ABSTRACT
O desenvolvimento da recorrência na área do traqueostoma em pacientes laringectomizados é uma das evoluções mais sérias do carcinoma epidermóide de laringe. Os fatores mais comumente associados a esta patologia são a extensão infraglótica do tumor laríngeo e a traqueostomia prévia à laringectomia. OBJETIVO: Identificar achados de exame clínico de pacientes laringectomizados relacionados com a possível gênese desta recorrência. FORMA DE ESTUDO: Estudo descritivo retrospectivo. CASUíSTICA E MÉTODOS: Foram analisados 47 pacientes laringectomizados em nosso hospital devido ao carcinoma epidermóide de laringe entre 1995 e 2004 e avaliado o número de recorrências, bem como os fatores de risco relacionados. RESULTADOS: A recorrência na área do traqueostoma desenvolveu-se em cinco (10,6 por cento) destes pacientes. Não houve correlação estatística entre a invasão infraglótica do tumor ou traqueostomia prévia com a recorrência na área do traqueostoma. CONCLUSÃO: A recorrência na área do traqueostoma continua sendo uma das evoluções fatais do câncer laríngeo, não sendo possível neste estudo identificar fatores relacionados com esta recorrência. Novos estudos com casuísticas maiores e longos períodos de seguimento são necessários no futuro para melhor compreensão desta patologia.
Stoma recurrence after total laryngectomy is one of the most severe developments of squamous cell carcinoma of the larynx. Risk factors most strongly implicated in stoma recurrence have been subglottic invasion by the laryngeal tumor and tracheotomy prior to laryngectomy. AIM: Study the clinical findings of patients who underwent total laryngectomy and evaluate the probable risk factors to the development of stoma recurrence. STUDY DESIGN: Descriptive and retrospective study MATERIALS AND METHODS: We studied data from 47 patients who underwent total laryngectomy for the treatment of laryngeal cancer between 1995 and 2004 and evaluated recurrences and risk factors. RESULTS: Stoma recurrence developed in 10.6 per cent of them(5 cases). There was no significant correlation between stoma recurrence and subglottic invasion or prior tracheotomy. CONCLUSION: Stoma recurrence still is one of the most lethal developments associated to laryngeal cancer. In the present study it was not possible to identify factors related to this recurrence. Further studies with a larger sample and a longer follow-up period are necessary to better understand this condition.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged, 80 and over , Laryngeal Neoplasms/surgery , Neoplasm Recurrence, Local , Neoplasms, Squamous Cell/surgery , Laryngectomy , Neoplasm Staging , Retrospective Studies , Risk Factors , TracheotomyABSTRACT
Objective To investigate the cause of stoma recurrence after anterior resection of rectal cancer and discover the methods of prevention and treatment.Methods A total 91 patients with stoma recurrence after anterior resection of rectal cancer (or Dixon) were analysed retrospectively between 1985 and 1996. Fourty seven patients experienced re radical resection (Miles), 27 cases palliative resection, and 11 cases only exploration. Thirty two cases had been followed up for 5 years and obtained 1,3,5 year survival rate for re radical radical resection (Miles). Diagnosis and treatment of stomal recurrence after Dixon were evaluated. Results One, three and five year survival rate of re radical resection (Miles) was 93%,77%,45% respectively.Conclusion To amplify blindly the adaptation of Dixon is to raise the rate of stoma recurrence. Digital rectal examination and fiberopic colonoscopy (and biopsy) are very essential methods for the diagnosis of stoma recurrence, and we strive to do re radical resection (Miles) for the patients with stoma recurrence after Dixon's operation.