Complications in transoral CO2 laser surgery for carcinoma of the larynx and hypopharynx
Article first published online: 18 NOV 2002
Copyright © 2003 Wiley Periodicals, Inc.
Head & Neck
Volume 25, Issue 5, pages 382–388, May 2003
How to Cite
Vilaseca-González, I., Bernal-Sprekelsen, M., Blanch-Alejandro, J.-L. and Moragas-Lluis, M. (2003), Complications in transoral CO2 laser surgery for carcinoma of the larynx and hypopharynx. Head Neck, 25: 382–388. doi: 10.1002/hed.10207
- Issue published online: 8 APR 2003
- Article first published online: 18 NOV 2002
- Manuscript Accepted: 12 AUG 2002
- laser surgery;
- larynx and hypopharynx carcinoma;
- complication rate;
- learning curve
Because of the increase in indications for laser surgery to treat malignant tumors of the larynx and hypopharynx, a higher number of complications may be expected. We prospectively evaluated the frequency and characteristics of intraoperative and postoperative complications of early and advanced tumors of the larynx and hypopharynx treated with CO2 laser surgery and the potential influence of the surgical learning curve on the complication rate.
Two hundred seventy-five patients operated in a tertiary referral center. Complications were classified either as major, requiring intensive medical treatment, blood transfusion, surgery, or ICU admission, or minor, resolving spontaneously or with conventional ambulatory treatment without sequelae. The surgical learning curve was analyzed by dividing the patients into two groups according to the date of surgery and then comparing the number of complications.
Complications occurred in 18.9% of patients; 9.8% were considered major and 9.1% minor. Complications included local infection (0.7%), emphysema (1%), cutaneous fistula (0.3%), postoperative bleeding (8%), airway ignition (0.3%), dyspnea (because of edema or stenosis) (1.8%), and swallowing difficulties or aspiration pneumonia (6.1%). The complication rate correlated significantly with tumor extension (p < .0001), the presence of diabetes mellitus (p = .01), and less surgical experience (p < .0001). Complications with severe sequelae occurred in two patients (p = .7).
Complications after transoral laser surgery of larynx and hypopharynx carcinomas are relatively frequent (18.9%), but serious sequelae and mortality rate are low. Complications are associated with tumor extension, limited surgical experience, and diabetes mellitus. © 2003 Wiley Periodicals, Inc. Head Neck 25: 000–000, 2003