Prevalence and Associated Risk Factors of Early Local Complications After Total Laryngectomy in Laryngeal Carcinoma Patients at Tikur Anbessa Hospital and Yekatit 12 Hospital Medical College: a Retrospective Study Over 5 Years.
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Date
2025-02
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Addis Ababa University
Abstract
Background: Laryngeal carcinoma is the most common site of malignancy in the head
and neck worldwide. Total laryngectomy is the standard surgical treatment for
management of locally advanced laryngeal and hypopharyngeal cancers. Complications
after total laryngectomy have significant impact on morbidity and health care cost, leading
to prolonged hospitalization, further operations, permanent sequelae, and sometimes a
fatal outcome. Studies from various countries report that the prevalence of early
postoperative complications after laryngectomy ranges from 9% to 25%. In Ethiopia, the
prevalence and risk factors of early local complications in total laryngetomy patients is not
yet studied.
Objective: To determine the prevalence and associated factors of early local
complications in laryngeal cancer patient who had total laryngectomy at Tikur Anbesa
Hospital and Yekatit 12 Hospital Medical College, Addis Ababa, Ethiopia, 2025.
Methods: A retrospective study design was conducted to determine the magnitude of
early local complication and associated risk factors in laryngeal cancer patients for whom
total laryngectomy was done at Tikur Anbesa Hospital and Yekatit 12 Hospital Medical
College, Addis Ababa, Ethiopia from January 1 to 30 2025. All patients with a diagnosis
of laryngeal cancer for who total laryngectomy was done at Tikur Anbesa Hospital and
Yekatit 12 Hospital Medical College from January 2019 to December 2024 were included.
Data were collected using a structured checklist questionnaire by using Kobo tool box was
imported to SPSS for analysis and interpretation. Descriptive statistics was used to
describe baseline patient characteristics. To identify the independent effects of the factors
logistic regression analysis was employed and those variables with a p value <0.05 was
considered as a significant predictor factor for early local laryngectomy complications.
Result: A total of 43 patients met the inclusion criteria and were enrolled in the study.
The mean age 58.52 years (SD = 12.21, range: 30–82 years). There were 41 males and 2
females with a ratio of 21 to 1. All patients 100% presented with voice change. A large
majority of patients 93.0% reported shortness of breath while throat pain/discomfort and
stridor present in 88.4% percent of patients each and the least was neck swelling in 16.3 %.
The majority of patients 83.7 % were diagnosed at TNM Stage IV with smaller proportion
16.3 % were at Stage III disease. Nodal stage of the disease shows 74.42% N0, 13.95%,
N1 and 11.63 % N2. Only smaller proportion (4.7%) had partial pharyngectomy.
Preoperative tracheostomy was done in 79.1% of patients. The most commonly used
neopharynx maturation was the vertical method (41.9%). Pharyngocutaneous fistula was
observed in 20.9% of cases. Wound infection, bleeding and hematoma, mortality rate,
chyle leak reported in 34.9%, 11.6%, 4.7%and 2.3% of cases respectively.
Conclusion: This study highlights that wound infection is the most prevalent
postoperative complication following total laryngectomy, affecting nearly one-third of
patients. Given the high prevalence of wound infections and pharyngocutaneous fistulas,
enhanced perioperative care, strict infection control measures, and optimized surgical
techniques are essential to improve patient outcomes. Further prospective studies are
recommended to better understand the risk factors and develop targeted interventions to
reduce postoperative complications in laryngeal cancer patients undergoing total
laryngectomy in Ethiopia.
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Keywords
laryngeal cancer, total laryngectomy, ealy laryngectomy complications