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 formanagement of locally advanced laryngeal and hypopharyngeal cancers. Complications after total laryngectomy have significant impact on morbidity and health care cost, leadingto prolonged hospitalization, further operations, permanent sequelae, and sometimes afatal outcome. Studies from various countries report that the prevalence of early postoperative complications after laryngectomy ranges from 9% to 25%. In Ethiopia, theprevalence and risk factors of early local complications in total laryngetomy patients is notyet studied.
Objective: To determine the prevalence and associated factors of early localcomplications in laryngeal cancer patient who had total laryngectomy at Tikur AnbesaHospital and Yekatit 12 Hospital Medical College, Addis Ababa, Ethiopia, 2025.
Methods: A retrospective study design was conducted to determine the magnitude ofearly local complication and associated risk factors in laryngeal cancer patients for whomtotal laryngectomy was done at Tikur Anbesa Hospital and Yekatit 12 Hospital MedicalCollege, Addis Ababa, Ethiopia from January 1 to 30 2025. All patients with a diagnosisof laryngeal cancer for who total laryngectomy was done at Tikur Anbesa Hospital andYekatit 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 wasconsidered 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 2females with a ratio of 21 to 1. All patients 100% presented with voice change. A largemajority 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 proportion16.3 % 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 wasobserved 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 prevalentpostoperative 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 surgicaltechniques are essential to improve patient outcomes. Further prospective studies arerecommended 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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laryngeal cancer total laryngectomy ealy laryngectomy complications