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[PMID]:29429176
[Au] Autor:Yang SZ; Zhou CY; Wang F; Sun BC; Han ZL; Shen Y; Han JH; Zhang HJ
[Ad] Endereço:Department of Otorhinolaryngology, First Affiliated Hospital to the People Liberation Army General Hospital, Beijing 100048, China.
[Ti] Título:[Analysis of curative effect of transoral radiofrequency ablation microsurgery on glottic carcinoma with anterior commissure involvement at the early stage].
[So] Source:Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi;53(2):86-91, 2018 Feb 07.
[Is] ISSN:1673-0860
[Cp] País de publicação:China
[La] Idioma:chi
[Ab] Resumo:To explore the key technique and outcome of transoral radiofrequency ablation microsurgery for early stage of glottic carcinoma with anterior commissure involvement (ACI). A retrospective analysis was conducted on 31 patients, who were diagnosed as early stage glottic carcinoma during January 2010 to March 2016 in ENT Department. According to whether the anterior commissure was involved or not, two groups were divided. There were eleven cases with ACI (stages T1a, T1b, and T2). Twenty cases without ACI (stages Tis, T1a, and T2). All the patients received transoral radiofrequency ablation microsurgery and followed up closely.Only one case received radiotheraphy after surgery. SPSS19.0 software was used to analyze data. The follow-up time was 12-67 months, and the median follow-up time was 30 months. Nine among 11 cases with ACI obtained good oncologic outcomes, initial local recurrence was identified in 2/11 cases, including 2 cases of T2. Two cases ultimately required salvage total laryngectomy. Meanwhile, initial local recurrence was identified in 2/20 cases without ACI, including 1 case of T1a and 1 case of T2. One case underwent elective neck dissection, and another one received salvage total laryngectomy.Compared to the patients without ACI, it seemed that the cases with ACI always accomponied with a little higher initial local recurrence and lower overall laryngealpreservation, but the difference had no significance ( >0.05). Transoral radiofrequency ablation microsurgery is an effective treatment for glottic carcinoma with ACI. Its advantages, such as more flexibility and deformability, make it more feasible to operate at the narrow space of anterior commissure assisted with laryngeal endoscopy.Good oncologic outcomes can be obtained by this technique with lower initial local recurrence as well as higher overall laryngeal preservation rate.
[Mh] Termos MeSH primário: Carcinoma/cirurgia
Ablação por Cateter/métodos
Neoplasias Laríngeas/cirurgia
Microcirurgia/métodos
[Mh] Termos MeSH secundário: Carcinoma/patologia
Glote
Seres Humanos
Neoplasias Laríngeas/patologia
Laringectomia
Laringoscopia
Terapia a Laser
Esvaziamento Cervical
Estudos Retrospectivos
Terapia de Salvação/métodos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180307
[Lr] Data última revisão:
180307
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180213
[St] Status:MEDLINE
[do] DOI:10.3760/cma.j.issn.1673-0860.2018.02.002


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[PMID]:29291278
[Au] Autor:van Loon Y; Hendriksma M; Langeveld TPM; de Jong MA; Baatenburg de Jong RJ; Sjögren EV
[Ad] Endereço:1 Department of Otorhinolaryngology, Head & Neck Surgery, Leiden University Medical Center, Leiden, the Netherlands.
[Ti] Título:Treatment Preferences in Patients With Early Glottic Cancer.
[So] Source:Ann Otol Rhinol Laryngol;127(3):139-145, 2018 Mar.
[Is] ISSN:1943-572X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: For early glottic carcinoma, the 2 main treatment modalities are radiotherapy (RT) and transoral CO laser microsurgery (TLM). The aim of this study was to investigate treatment preferences and considerations in patients with early glottic carcinoma (T1-T2) who were given a choice between TLM and RT. SUBJECTS AND METHODS: Patients with early glottic cancer (suspected or confirmed extended T1 or limited T2) were counseled by an ENT-surgeon. A subset of 32 patients was also counseled by a radiotherapist. Treatment choice and considerations were recorded and analyzed. RESULTS: Of 175 patients, 168 patients (96%) chose TLM, and 7 patients (4%) chose RT. The most common reason for choosing TLM was shorter treatment and more treatment options in case of recurrence. Subanalysis showed that additional counseling by the radiotherapist did not seem to affect our patients' preferences for TLM in this group. CONCLUSIONS: The majority of patients in our study prefer TLM to RT when given a choice. Reasons given indicate that optimizing future treatment options and practical considerations seemed more important to our patients than primary functional outcome. Further research is needed to study patient-related and physician-related factors to gain more insight into this complicated process of shared decision making.
[Mh] Termos MeSH primário: Carcinoma
Glote/patologia
Neoplasias Laríngeas
Terapia a Laser
Preferência do Paciente/estatística & dados numéricos
Radioterapia
[Mh] Termos MeSH secundário: Carcinoma/patologia
Carcinoma/psicologia
Carcinoma/terapia
Feminino
Seres Humanos
Neoplasias Laríngeas/patologia
Neoplasias Laríngeas/psicologia
Neoplasias Laríngeas/terapia
Terapia a Laser/métodos
Terapia a Laser/psicologia
Terapia a Laser/estatística & dados numéricos
Masculino
Microcirurgia/métodos
Meia-Idade
Recidiva Local de Neoplasia
Estadiamento de Neoplasias
Países Baixos
Radioterapia/métodos
Radioterapia/psicologia
Radioterapia/estatística & dados numéricos
Estudos Retrospectivos
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180302
[Lr] Data última revisão:
180302
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180102
[St] Status:MEDLINE
[do] DOI:10.1177/0003489417749253


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[PMID]:28904716
[Au] Autor:Hemmaoui B; Sahli M; Errami N; Rouihi A; Bahalou MH; Benchaifai I; Ennouali A; Britel S; Nakkabi I; Jahidi A; Zalagh M; Ouaraini S; Benariba F
[Ad] Endereço:Service d'ORL et Chirurgie Cervico-faciale, Hôpital d'Instruction Militaire Mohamed V, Rabat, Maroc.
[Ti] Título:[Supracricoid partial laryngectomy (SCPL) with either cricohyoidoepiglottopexy (CHEP): our experience with 16 cases].
[Ti] Título:Laryngectomies partielles supra-cricoïdiennes avec reconstruction par CHEP: notre expérience sur 16 cas..
[So] Source:Pan Afr Med J;27:191, 2017.
[Is] ISSN:1937-8688
[Cp] País de publicação:Uganda
[La] Idioma:fre
[Ab] Resumo:Partial laryngectomy with either cricohyoidoepiglottopexy (CHEP) are mainly used to treat glottic cancers becuse they ensure a satisfactory preservation of physiological functions and satisfactory local carcinologic control. Our study aimed to analyze the functional and carcinologic results of this surgical technique. We conducted a retrospective study of patients undergoing partial laryngectomy with either cricohyoidoepiglottopexy in our Hospital between 2011 and 2014. We analyzed the epidemiological data, the surgical peculiarities, the functional outcomes and the carcinologic control of the disease. A total of 16 patients were included in this study. All our patients had T1 or T2 glottis squamous cell carcinoma. Functional outcomes were generally simple, especially in cases where the preservation of the 2 cricoarytenoid units was possible (75% of cases). However post-operative complications were reported in 31.25%. Carcinologic control was satisfactory, only one patient experienced local recurrence. Partial laryngectomy with either cricohyoidoepiglottopexy (CHEP) is a safe surgery preserving physiological functions and ensuring satisfactory quality of life. It also allows for good carcinologic control (it is subject of course to compliance with surgical indications).
[Mh] Termos MeSH primário: Carcinoma de Células Escamosas/cirurgia
Glote/cirurgia
Neoplasias de Cabeça e Pescoço/cirurgia
Neoplasias Laríngeas/cirurgia
Laringectomia/métodos
[Mh] Termos MeSH secundário: Carcinoma de Células Escamosas/patologia
Glote/patologia
Neoplasias de Cabeça e Pescoço/patologia
Seres Humanos
Neoplasias Laríngeas/patologia
Masculino
Meia-Idade
Recidiva Local de Neoplasia
Complicações Pós-Operatórias/epidemiologia
Qualidade de Vida
Estudos Retrospectivos
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170922
[Lr] Data última revisão:
170922
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170915
[St] Status:MEDLINE
[do] DOI:10.11604/pamj.2017.27.191.11955


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[PMID]:28859114
[Au] Autor:Kriege M; Alflen C; Noppens RR
[Ad] Endereço:Department of Anesthesiology, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany.
[Ti] Título:Using King Vision video laryngoscope with a channeled blade prolongs time for tracheal intubation in different training levels, compared to non-channeled blade.
[So] Source:PLoS One;12(8):e0183382, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: It is generally accepted that using a video laryngoscope is associated with an improved visualization of the glottis. However, correctly placing the endotracheal tube might be challenging. Channeled video laryngoscopic blades have an endotracheal tube already pre-loaded, allowing to advance the tube once the glottis is visualized. We hypothesized that use of a channel blade with pre-loaded endotracheal tube results in a faster intubation, compared to a curved Macintosh blade video laryngoscope. METHODS: After ethical approval and informed consent, patients were randomized to receive endotracheal Intubation with either the King Vision® video laryngoscope with curved blade (control) or channeled blade (channeled). Success rate, evaluation of the glottis view (percentage of glottic opening (POGO), Cormack&Lehane (C&L)) and intubating time were evaluated. RESULTS: Over a two-month period, a total of 46 patients (control n = 23; channeled n = 23) were examined. The first attempt success rates were comparable between groups (control 100% (23/23) vs. channeled 96% (22/23); p = 0.31). Overall intubation time was significantly shorter with control (median 40 sec; IQR [24-58]), compared to channeled (59 sec [40-74]; p = 0.03). There were no differences in glottis visualization between groups. CONCLUSION: Compared with the King Vision channeled blade, time for tracheal intubation was shorter with the control group using a non-channeled blade. First attempt success and visualization of the glottis were comparable. These data do not support the hypothesis that a channeled blade is superior to a curved video laryngoscopic blade without tube guidance. TRIAL REGISTRATION: ClinicalTrials.gov NCT02344030.
[Mh] Termos MeSH primário: Glote/cirurgia
Intubação Intratraqueal/métodos
Laringoscópios
Cirurgia Vídeoassistida/métodos
[Mh] Termos MeSH secundário: Adulto
Idoso
Feminino
Glote/fisiopatologia
Seres Humanos
Intubação Intratraqueal/instrumentação
Masculino
Meia-Idade
Cirurgia Vídeoassistida/instrumentação
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171016
[Lr] Data última revisão:
171016
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170901
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0183382


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[PMID]:28787340
[Au] Autor:Efrati S; Bolotin G; Levi L; Zaaroor M; Guralnik L; Weksler N; Levinger U; Soroksky A; Denman WT; Gurman GM
[Ad] Endereço:From the *Assaf-Harofeh Medical Center, Zerifin, Israel; †Sackler School of Medicine and Sagol School of Neuroscience, Tel-Aviv University, Tel-Aviv, Israel; ‡Cardiac Surgery, Rambam Health Care Campus, Haifa, Israel; §Technion-Institute of Technology, Faculty of Medicine, Haifa, Israel; ∥Mayanei HaYeshua Medical Center, B'nai Brak, Israel; ¶Laniado Medical Center, Netanya, Israel; #Wolfson Medical Center, Holon, Israel; **Massachusetts General Hospital, Boston, Massachusetts; ††Harvard Medical School, Boston, Massachusetts; and ‡‡Ben-Gurion University of the Negev, Beer Sheva, Israel.
[Ti] Título:Optimization of Endotracheal Tube Cuff Pressure by Monitoring CO2 Levels in the Subglottic Space in Mechanically Ventilated Patients: A Randomized Controlled Trial.
[So] Source:Anesth Analg;125(4):1309-1315, 2017 Oct.
[Is] ISSN:1526-7598
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Many of the complications of mechanical ventilation are related to inappropriate endotracheal tube (ETT) cuff pressure. The aim of the current study was to evaluate the effectiveness of automatic cuff pressure closed-loop control in patients under prolonged intubation, where presence of carbon dioxide (CO2) in the subglottic space is used as an indicator for leaks. The primary outcome of the study is leakage around the cuff quantified using the area under the curve (AUC) of CO2 leakage over time. METHODS: This was a multicenter, prospective, randomized controlled, noninferiority trial including intensive care unit patients. All patients were intubated with the AnapnoGuard ETT, which has an extra lumen used to monitor CO2 levels in the subglottic space.The study group was connected to the AnapnoGuard system operating with cuff control adjusted automatically based on subglottic CO2 (automatic group). The control group was connected to the AnapnoGuard system, while cuff pressure was managed manually using a manometer 3 times/d (manual group). The system recorded around cuff CO2 leakage in both groups. RESULTS: Seventy-two patients were recruited and 64 included in the final analysis. The mean hourly around cuff CO2 leak (mm Hg AUC/h) was 0.22 ± 0.32 in the manual group and 0.09 ± 0.04 in the automatic group (P = .01) where the lower bound of the 1-sided 95% confidence interval was 0.05, demonstrating noninferiority (>-0.033). Additionally, the 2-sided 95% confidence interval was 0.010 to 0.196, showing superiority (>0.0) as well. Significant CO2 leakage (CO2 >2 mm Hg) was 0.027 ± 0.057 (mm Hg AUC/h) in the automatic group versus 0.296 ± 0.784 (mm Hg AUC/h) in the manual group (P = .025). In addition, cuff pressures were in the predefined safety range 97.6% of the time in the automatic group compared to 48.2% in the automatic group (P < .001). CONCLUSIONS: This study shows that the automatic cuff pressure group is not only noninferior but also superior compared to the manual cuff pressure group. Thus, the use of automatic cuff pressure control based on subglottic measurements of CO2 levels is an effective method for ETT cuff pressure optimization. The method is safe and can be easily utilized with any intubated patient.
[Mh] Termos MeSH primário: Dióxido de Carbono/análise
Glote/química
Monitorização Neurofisiológica Intraoperatória/normas
Intubação Intratraqueal/instrumentação
Intubação Intratraqueal/normas
Respiração Artificial/normas
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Feminino
Seres Humanos
Monitorização Neurofisiológica Intraoperatória/métodos
Intubação Intratraqueal/métodos
Laringe/química
Masculino
Meia-Idade
Estudos Prospectivos
Respiração Artificial/efeitos adversos
Respiração Artificial/métodos
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
142M471B3J (Carbon Dioxide)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171004
[Lr] Data última revisão:
171004
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170809
[St] Status:MEDLINE
[do] DOI:10.1213/ANE.0000000000002358


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[PMID]:28733315
[Au] Autor:Lamb KD; Kriner EJ
[Ad] Endereço:INOVA Fairfax Medical Campus Falls Church, VA lambrrt@gmail.com.
[Ti] Título:Evaluation of the Safety and Effectiveness of the Rapid Flow Expulsion Maneuver to Clear Subglottic Secretions In Vitro and In Vivo.
[So] Source:Respir Care;62(8):1111-1112, 2017 08.
[Is] ISSN:1943-3654
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Glote
Intubação Intratraqueal
[Mh] Termos MeSH secundário: Seres Humanos
[Pt] Tipo de publicação:EDITORIAL; COMMENT
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170814
[Lr] Data última revisão:
170814
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170723
[St] Status:MEDLINE
[do] DOI:10.4187/respcare.05737


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[PMID]:28721883
[Au] Autor:Stokes WA; Abbott D; Phan A; Raben D; Lanning RM; Karam SD
[Ad] Endereço:Department of Radiation Oncology, University of Colorado School of Medicine, Aurora, Colorado.
[Ti] Título:Patterns of Care for Patients With Early-Stage Glottic Cancer Undergoing Definitive Radiation Therapy: A National Cancer Database Analysis.
[So] Source:Int J Radiat Oncol Biol Phys;98(5):1014-1021, 2017 Aug 01.
[Is] ISSN:1879-355X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: To characterize practice patterns, including temporal trends, in fractionation schedules among patients in the United States undergoing definitive radiation therapy for early-stage glottic cancer and to compare overall survival outcomes between fractionation schedules. METHODS AND MATERIALS: We queried the National Cancer Database for patients with TisN0M0, T1N0M0, or T2N0M0 squamous cell carcinoma of the glottic larynx diagnosed between 2004 and 2012 and undergoing definitive radiation therapy. Dose per fraction was calculated to define cohorts undergoing conventional fractionation (CFxn) and hypofractionation (HFxn). Logistic regression was performed to identify predictors of receiving HFxn, and Cox regression was used to determine predictors of death. One-to-one propensity score matching was then used to compare survival between fractionation schedules. RESULTS: The study included 10,539 patients, with 6576 undergoing CFxn and 3963 undergoing HFxn. Patients with T1 disease comprised a majority of each cohort. Use of HFxn increased significantly over the period studied (P<.001), but even in the final year, nearly one-half of patients continued to receive CFxn. Receipt of HFxn was also independently associated with higher income and facility types other than community cancer programs on logistic regression. On multivariate Cox regression, HFxn was associated with improved survival (hazard ratio [HR] for death, 0.90; 95% confidence interval [CI], 0.83-0.97; P=.008), a finding redemonstrated on univariate Cox regression among a well-matched cohort after propensity score matching (HR, 0.88; 95% CI, 0.80-0.96; P=.003). Subgroup Cox multivariate analysis demonstrated a significant survival advantage with HFxn among patients with T1 disease (HR, 0.90; 95% CI, 0.81-0.99; P=.042) but a nonsignificant benefit among those with Tis (HR, 0.86; 95% CI, 0.57-1.30; P=.472) or T2 (HR, 0.88; 95% CI, 0.76-1.02; P=.099) disease. CONCLUSIONS: Use of HFxn is increasing and is associated with improved survival over CFxn. Our findings support the broadened use of HFxn for patients with early-stage glottic cancer undergoing definitive radiation therapy.
[Mh] Termos MeSH primário: Carcinoma de Células Escamosas/mortalidade
Carcinoma de Células Escamosas/radioterapia
Radioterapia Hipofracionada
Neoplasias Laríngeas/mortalidade
Neoplasias Laríngeas/radioterapia
[Mh] Termos MeSH secundário: Idoso
Carcinoma de Células Escamosas/patologia
Grupos de Populações Continentais
Bases de Dados Factuais/estatística & dados numéricos
Fracionamento de Dose
Feminino
Glote
Acesso aos Serviços de Saúde
Seres Humanos
Cobertura do Seguro/estatística & dados numéricos
Estimativa de Kaplan-Meier
Neoplasias Laríngeas/patologia
Modelos Logísticos
Masculino
Meia-Idade
Estadiamento de Neoplasias
Pontuação de Propensão
Modelos de Riscos Proporcionais
Fatores Socioeconômicos
Fatores de Tempo
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170814
[Lr] Data última revisão:
170814
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170720
[St] Status:MEDLINE


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[PMID]:28714430
[Au] Autor:Bannon R; Gohil R; Manickavasagam J
[Ad] Endereço:School of Medicine,University of St Andrews,Scotland,UK.
[Ti] Título:Laparoscopic instrument use in laryngeal surgery: transoral resection of a supraglottic haemangioma.
[So] Source:J Laryngol Otol;131(9):823-826, 2017 Sep.
[Is] ISSN:1748-5460
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Adult laryngeal haemangiomas are rare vascular tumours that have been managed by a variety of surgical techniques. METHODS: This paper describes a case of near-fatal acute airway obstruction secondary to such a lesion, followed by our approach to surgical resection using a laparoscopic bipolar tissue-sealing device. RESULTS: This technique resulted in successful excision of the lesion, with no evidence of recurrence at one year of follow up. CONCLUSION: Laparoscopic bipolar instruments can be used for the resection of moderate to large laryngeal haemangiomas as an alternative to laser excision.
[Mh] Termos MeSH primário: Glote/cirurgia
Hemangioma/cirurgia
Neoplasias Laríngeas/cirurgia
Laringectomia/instrumentação
[Mh] Termos MeSH secundário: Adulto
Glote/patologia
Seres Humanos
Masculino
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170915
[Lr] Data última revisão:
170915
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170718
[St] Status:MEDLINE
[do] DOI:10.1017/S0022215117001438


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[PMID]:28708883
[Au] Autor:Brandstorp-Boesen J; Sørum Falk R; Boysen M; Brøndbo K
[Ad] Endereço:University of Oslo, Faculty of Medicine, Institute of Clinical Medicine, Oslo, Norway.
[Ti] Título:Impact of stage, management and recurrence on survival rates in laryngeal cancer.
[So] Source:PLoS One;12(7):e0179371, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:A retrospective, longitudinal study of 1,616 patients with primary laryngeal squamous cell carcinoma (LSCC) at a single center in Norway during 1983-2010 was undertaken to investigate overall survival, disease specific survival, disease-free survival, prognostic factors for overall survival, and impact of recurrence among all-stage laryngeal cancer patients over 15 years' follow-up. The prognostic impact of gender, age, smoking/alcohol, subsite, tumour, node and metastasis staging, period and modality of treatment were evaluated using Kaplan-Meier and Cox proportional hazard analyses. The importance of recurrence on survival was assessed based on case fatality rates. Five-year overall survival was 56.8%, 64.0% and 38.8%, and disease-specific survival was 80.2%, 87% and 61.6%, respectively, for the entire cohort and for glottic and supraglottic LSCC. Old age, advanced-stage LSCC and supraglottic cancer were associated with lower overall survival. The risk of disease-specific death plateaued after five years and varied significantly by subsite. Multivariate analysis of glottic LSCC revealed that surgical treatment improved overall survival, whereas old age, alcohol, T3-T4 status, positive N-status and no treatment were associated with worse survival. In supraglottic LSCC, age, alcohol, and positive N-status had a significant impact on overall survival by multivariate analysis. Five-year overall survival and disease-specific survival among patients with recurrent disease were 34% and 52%, respectively. In conclusion, marked difference in overall survival between glottic and supraglottic LSCC underline the importance of subsite-specific survival analysis. T-status and primary surgical management is essential only for glottic LSCC, emphasizing the importance of correct disease classification. Inferior outcomes in supraglottic LSCC are associated with old age, positive N-status, and improved follow-up routines are necessary. Primary tumor control is essential since recurrence impairs survival considerably in all subsites. The potential benefit of a primary surgical approach towards T3 LSCC awaits further investigation.
[Mh] Termos MeSH primário: Carcinoma de Células Escamosas/patologia
Neoplasias de Cabeça e Pescoço/patologia
Neoplasias Laríngeas/patologia
[Mh] Termos MeSH secundário: Idoso
Consumo de Bebidas Alcoólicas
Carcinoma de Células Escamosas/mortalidade
Intervalo Livre de Doença
Feminino
Glote/patologia
Neoplasias de Cabeça e Pescoço/mortalidade
Seres Humanos
Estimativa de Kaplan-Meier
Neoplasias Laríngeas/mortalidade
Estudos Longitudinais
Masculino
Meia-Idade
Recidiva Local de Neoplasia
Estadiamento de Neoplasias
Prognóstico
Modelos de Riscos Proporcionais
Estudos Retrospectivos
Fatores de Risco
Fumar
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170926
[Lr] Data última revisão:
170926
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170715
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0179371


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[PMID]:28688573
[Au] Autor:Cooper T; Harris B; Mourad A; Garros D; El-Hakim H
[Ad] Endereço:Division of Otolaryngology-Head and Neck Surgery, Canada.
[Ti] Título:Comparison between selective and routine intensive care unit admission post-supraglottoplasty.
[So] Source:Int J Pediatr Otorhinolaryngol;99:90-94, 2017 Aug.
[Is] ISSN:1872-8464
[Cp] País de publicação:Ireland
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To compare major post-operative respiratory complications, post-operative disposition and duration of hospital admission before and after adopting a selective intensive care unit (ICU) admission care plan following supraglottoplasty (SGP). METHODS: Retrospective case series set in a tertiary pediatric referral center. Eligible patients undergoing SGP between October 2003 and July 2015 were identified through a prospectively kept surgical database. Historical cohorts with routine admission to ICU and selective admission to ICU were identified based on a shift in surgeon practice. The cohorts were compared with respect to demographics, presenting features, endoscopic findings, baseline sleep and swallowing study results, major respiratory complications (including repeat or unplanned ICU admission or intubation) and length of post-operative hospital admission. RESULTS: 141 eligible patients were identified with 35 children in the routine ICU admission cohort and 106 in the selective ICU admission cohort. There were no significant differences between cohorts regarding major respiratory complications with only one patient in the selective ICU admission cohort requiring an unplanned admission to ICU (P = 1.00, Fisher's exact test). This gives a number needed to harm of 78 step-down unit admissions for 1 unplanned ICU admission. The rate of ICU admission was reduced from 71% to 26% with adoption of a selective ICU admission care plan (p < 0.01, χ ). Mean duration of post-operative hospitalization was reduced from 5.1 ± 3.5 days to 1.9 ± 2.3 days (P < 0.01, Student's t-test). CONCLUSIONS: Selective post-operative ICU admission following SGP significantly reduces ICU utilization and may reduce length of hospital stay without compromising safety and care. This has significant cost benefit implications.
[Mh] Termos MeSH primário: Glote/cirurgia
Unidades de Terapia Intensiva/estatística & dados numéricos
Laringomalácia/cirurgia
Admissão do Paciente/estatística & dados numéricos
Complicações Pós-Operatórias/epidemiologia
[Mh] Termos MeSH secundário: Adolescente
Criança
Pré-Escolar
Análise Custo-Benefício
Bases de Dados Factuais
Feminino
Hospitalização/estatística & dados numéricos
Seres Humanos
Lactente
Tempo de Internação/estatística & dados numéricos
Masculino
Estudos Retrospectivos
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170803
[Lr] Data última revisão:
170803
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170710
[St] Status:MEDLINE



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