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[PMID]:29287881
[Au] Autor:Ünsaler S; Basaran B; Aslan I; Yilmazbayhan D
[Ad] Endereço:Department of Otolaryngology, Acibadem Altunizade Hospital, Üsküdar, Istanbul, 34662, Turkey. Electronic address: selinunsaler@gmail.com.
[Ti] Título:Endonasal endoscopic nasopharyngectomy for the treatment of nasopharyngeal papillary adenocarcinoma: Report of a rare case.
[So] Source:Int J Pediatr Otorhinolaryngol;104:51-53, 2018 Jan.
[Is] ISSN:1872-8464
[Cp] País de publicação:Ireland
[La] Idioma:eng
[Ab] Resumo:We report a case of low-grade nasopharyngeal papillary adenocarcinoma in a 9 year-old male that was diagnosed incidentally after an adenoidectomy procedure and treated with endonasal endoscopic nasopharyngectomy without any adjuvant therapy. The patient has been followed up for 3 years with no evidence of recurrence. We point out the importance of preoperative fiberoptic nasopharyngoscopy in the absence of longstanding symptoms in school-aged children and histopathologic examination of adenoidectomy specimens in the presence of atypical findings. We also suggest endonasal endoscopic resection in case of papillary adenocarcinoma.
[Mh] Termos MeSH primário: Adenocarcinoma Papilar/cirurgia
Carcinoma/cirurgia
Endoscopia/métodos
Neoplasias Nasofaríngeas/cirurgia
Faringectomia/métodos
[Mh] Termos MeSH secundário: Adenoidectomia
Criança
Seres Humanos
Masculino
Procedimentos Cirúrgicos Nasais/métodos
Nariz/patologia
Nariz/cirurgia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171231
[St] Status:MEDLINE


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[PMID]:28570758
[Au] Autor:Roman BR; Baxi SS; Cracchiolo JR; Blackwell TJ; Pfister DG; McBride S; Ganly I; Shah JP; Patel SG; Morris LG; Cohen MA
[Ad] Endereço:Memorial Sloan Kettering Cancer Center, New York, New York.
[Ti] Título:Variation in use of postoperative chemoradiation following surgery for T1 and T2 oropharyngeal squamous cell carcinoma; National Cancer Database.
[So] Source:J Surg Oncol;116(3):351-358, 2017 Sep.
[Is] ISSN:1096-9098
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND AND OBJECTIVES: Primary surgical treatment of patients with early T-classification (T1-T2) oropharyngeal squamous cell carcinoma (OPSCC) has increased. We sought to determine how often these patients receive postoperative chemoradiation (CRT). METHODS: Patients with T1-T2 OPSCC in the National Cancer Database who underwent primary surgery were evaluated for receipt of postoperative CRT. Postoperative CRT use was examined among patients with high risk factors (positive margins and/or extracapsular spread [ECS]), intermediate risk factors (negative margins, no ECS, and either pT3-4 and/or N2-N3), and no apparent risk factors. RESULTS: Of 4833 patients with T1-T2 OPSCC who underwent primary surgery, 43% had high risk pathologic factors, of whom only 63% received postoperative CRT. Another 31% had no apparent risk factors, of whom 16% nonetheless received postoperative CRT. On multivariable analysis, in addition to tumor and demographic factors, patients treated at community hospitals were more likely to receive postoperative CRT (O.R. 1.41 C.I. 1.18-1.87, P = 0.001). CONCLUSIONS: Variation in postoperative CRT use indicates a lack of consensus and/or knowledge about its benefits and indications. Usage of postoperative CRT regardless of pathologic risk factors suggests an area where future efforts at implementation of best practices may be targeted.
[Mh] Termos MeSH primário: Carcinoma de Células Escamosas/terapia
Quimiorradioterapia Adjuvante
Neoplasias Orofaríngeas/terapia
Faringectomia
Cuidados Pós-Operatórios
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Carcinoma de Células Escamosas/patologia
Estudos de Coortes
Bases de Dados Factuais
Feminino
Seres Humanos
Masculino
Meia-Idade
Neoplasias Orofaríngeas/patologia
Fatores de Risco
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170908
[Lr] Data última revisão:
170908
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170602
[St] Status:MEDLINE
[do] DOI:10.1002/jso.24674


  3 / 1168 MEDLINE  
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[PMID]:28558456
[Au] Autor:Qiu QH; Li N; Zhang QH; Chen Z; Huang Y; Jiang Y; Yang XT
[Ad] Endereço:Department of Otorhinolaryngology Head and Neck Surgery, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China.
[Ti] Título:[Clinical efficacy of endoscopic nasopharyngectomy for initially diagnosed advanced nasopharyngeal carcinoma].
[So] Source:Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi;52(5):365-371, 2017 May 07.
[Is] ISSN:1673-0860
[Cp] País de publicação:China
[La] Idioma:chi
[Ab] Resumo:To explore the clinical efficacy in patients who underwent endoscopic nasopharyngectomy for primary advanced nasopharyngeal carcinoma (NPC). Forty-five patients who underwent endoscopic nasopharyngectomy for primary advanced NPC encountered between Aug. 2007 and Sep. 2015 were retrospectively reviewed. Twenty-seven patients were male (60.0%), and 18 patients were female (40.0%), the ratio of male to female was 3∶2. The median age was 53 years old (ranged from 13 to 75 years old). The median onset time was 5 months (ranged from 1 to 72 months). TNM stage: 16 cases were at stage â…¢ (35.6%), 29 at stage â…£ (64.4%); T3 16 cases (35.6%), T4 29 cases (64.4%); N0 38 cases (84.4%), N2 7 cases (15.6%). No patients were found to have distance metastasis. All patients underwent endoscopic resection of lesions. Postoperatively all the patients were treated with radiotherapy or chemoradiotherapy. Using SPSS 19.0 software, - and - test were done for the assessmen of survival rate; proportional hazards model was used for the univariate analysis of prognostic factors. The median follow-up was 36 months (ranged from 6 to 97 months), with 36 cases surviving (80.0%), 9 cases died (20.0%); 15 cases relapsed (33.3%). The overall 1 year survival rates (SR), 3 year SR, 5 year SR was 90.6%, 81.0%, 76.0%, respectively. The survival univariate analysis indicated the recurrence and metastasis were correlated with the survival (χ(2) value was 16.644, 6.451, respectively, all <0.05). The patients who undergo endoscopic nasopharyngectomy for primary advanced NPC have better survival rate with lower recurrent rate and metastatic rate.
[Mh] Termos MeSH primário: Carcinoma/cirurgia
Neoplasias Nasofaríngeas/cirurgia
Faringectomia/métodos
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Análise de Variância
Carcinoma/mortalidade
Carcinoma/patologia
Endoscopia
Feminino
Seres Humanos
Masculino
Meia-Idade
Neoplasias Nasofaríngeas/mortalidade
Neoplasias Nasofaríngeas/patologia
Recidiva Local de Neoplasia
Estadiamento de Neoplasias
Modelos de Riscos Proporcionais
Estudos Retrospectivos
Taxa de Sobrevida
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170823
[Lr] Data última revisão:
170823
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170601
[St] Status:MEDLINE
[do] DOI:10.3760/cma.j.issn.1673-0860.2017.05.009


  4 / 1168 MEDLINE  
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[PMID]:28532519
[Au] Autor:Pinto V; Morselli PG; Tassone D; Piccin O
[Ad] Endereço:Department of Plastic and Reconstructive Surgery,S Orsola-Malpighi University Hospital,Bologna,Italy.
[Ti] Título:A case of severe obstructive sleep apnoea in Madelung's disease treated by lateral pharyngoplasty.
[So] Source:J Laryngol Otol;131(9):834-837, 2017 Sep.
[Is] ISSN:1748-5460
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Madelung's disease is a rare disorder characterised by the presence of multiple, symmetric, non-capsulated fat masses in the face, neck and other areas of upper extremities. In some cases, severe clinical complications such as upper airway compression can occur. CASE REPORT: A 56-year-old man affected by Madelung's disease complained of snoring and severe daytime sleepiness. Polysomnography revealed severe obstructive sleep apnoea. An attempt to treat sleep apnoea by continuous positive airway pressure failed because of poor compliance. Functional expansion pharyngoplasty was carried out as an initial treatment. Marked improvement of neck movements and normalisation of somnographic parameters were observed at six months' follow up. CONCLUSION: Patients with Madelung's disease should be examined carefully for potential obstructive sleep apnoea. Although continuous positive airway pressure remains the treatment of choice, specific surgery can be used in those patients who cannot tolerate continuous positive airway pressure therapy.
[Mh] Termos MeSH primário: Lipomatose Simétrica Múltipla/complicações
Faringectomia/métodos
Apneia Obstrutiva do Sono/cirurgia
[Mh] Termos MeSH secundário: Seres Humanos
Masculino
Meia-Idade
Polissonografia
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:170524
[St] Status:MEDLINE
[do] DOI:10.1017/S0022215117001062


  5 / 1168 MEDLINE  
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[PMID]:28375474
[Au] Autor:Banerjee JK; Saranga Bharathi R
[Ti] Título:Minimally invasive substernal colonic transposition for corrosive strictures of the upper aerodigestive tract.
[So] Source:Dis Esophagus;30(4):1-11, 2017 Apr 01.
[Is] ISSN:1442-2050
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Corrosive upper aerodigestive tract strictures are conventionally treated by open surgery. Surgical advancements permit these strictures to be addressed with minimal invasion. Corrosive strictures treated minimally invasively over a 2-year period (2014-2015) were audited. Colonic mobilization and retrosternal tunneling were performed laparoscopically. The left colic vessel-based isoperistaltic colonic/ileocolonic segment was transposed substernally into the neck, aided by miniceliotomy. Proximal anastomosis was side-to-side esophagocolic in all patients except those who underwent pharyngolaryngectomy or partial laryngectomy, where pharyngocolic/pyriform fossa-ileal anastomosis was employed. Distal anastomoses were colo-jejunal and colocolic/ileocolic in all the patients. Enteral nutrition and ambulation were commenced on the first postoperative day. Oral nutrition was commenced following a normal contrast swallow on the seventh postoperative day. Patients were followed up on an outpatient basis. Ten adults, aged between 19 and 40 years, were treated for acid-induced strictures. Esophagus and stomach were multiply strictured in all patients. Additionally, duodenum was involved in two patients while pharynx and larynx were strictured in three patients. Two patients underwent pharyngolaryngectomy. One patient underwent partial laryngectomy. The average operative time was 240 minutes (range: 210-300 minutes). The mean blood loss was 150 mL (range: 100-200 mL). One patient (10%) had cervical anastomotic leak on the ninth postoperative day, which was resolved spontaneously. One patient (10%) had proximal anastomotic stricture, requiring dilatation thrice. One patient (10%) had the transient left recurrent laryngeal nerve paresis, which was resolved spontaneously. All the patients are on oral solid diet. The followup ranged from 5 months to 2 years. Minimal access substernal colonic transposition is feasible and efficacious in restoring alimentary continuity in corrosive strictures.
[Mh] Termos MeSH primário: Queimaduras Químicas/cirurgia
Colo/cirurgia
Estenose Esofágica/cirurgia
Faringe/cirurgia
Trato Gastrointestinal Superior/cirurgia
[Mh] Termos MeSH secundário: Adulto
Anastomose Cirúrgica/métodos
Queimaduras Químicas/complicações
Cáusticos/toxicidade
Colo/lesões
Colo/patologia
Constrição Patológica
Estenose Esofágica/induzido quimicamente
Feminino
Seres Humanos
Laparoscopia/métodos
Laringectomia
Laringe/lesões
Laringe/patologia
Laringe/cirurgia
Masculino
Auditoria Médica
Duração da Cirurgia
Faringectomia
Faringe/lesões
Faringe/patologia
Resultado do Tratamento
Trato Gastrointestinal Superior/lesões
Trato Gastrointestinal Superior/patologia
Adulto Jovem
[Pt] Tipo de publicação:EVALUATION STUDIES; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Caustics)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171011
[Lr] Data última revisão:
171011
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170405
[St] Status:MEDLINE
[do] DOI:10.1093/dote/dow030


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[PMID]:28325565
[Au] Autor:Nouraei SA; Dias A; Kanona H; Vokes D; O'Flynn P; Clarke PM; Middleton SE; Darzi A; Aylin P; Jallali N
[Ad] Endereço:Department of Ear Nose and Throat Surgery, Auckland City Hospital, Grafton, Auckland, New Zealand. Electronic address: RN@cantab.net.
[Ti] Título:Impact of the method and success of pharyngeal reconstruction on the outcome of treating laryngeal and hypopharyngeal cancers with pharyngolaryngectomy: A national analysis.
[So] Source:J Plast Reconstr Aesthet Surg;70(5):628-638, 2017 May.
[Is] ISSN:1878-0539
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Surgical treatment of cancers that arise from or invade the hypopharynx presents major reconstructive challenges. Reconstructive failure exposes the airway and neck vessels to digestive contents. METHODS: We performed a national N = near-all analysis of the administrative dataset to identify pharyngolaryngectomies in England between 2002 and 2012. Information about morbidity, pharyngeal closure method and post-operative complications was derived. RESULTS: There were 1589 predominantly male (78%) patients whose mean age at surgery was 62 years. The commonest morbidities were hypertension (24%) and ischemic heart disease (11%). For 232 (15%) patients, pharyngolaryngectomy was performed during an emergency admission. The pharynx was closed primarily in 551 patients, with skin or muscle free or pedicled flaps in 755 patients and with jejunum and gastric pull-up in 123 and 160 patients, respectively. In-hospital mortality rate was 6% and was significantly higher in the gastric pull-up group (11%). Reconstructive failure had an odds ratio of 6.2 [95% confidence interval (CI) 2.4-16.1] for in-hospital death. The five-year survival was 57% and age, morbidities, emergency surgery, gastric pull-up, major acute cardiovascular events, renal failure and reconstructive failure independently worsened prognosis. Patients who underwent pharyngeal reconstruction with radial forearm or anterolateral thigh flaps had lower mortality rates than patients who had jejunum flap reconstruction (hazard ratio = 1.50 [95% CI 1.03-2.19]) or gastric pull-up (hazard ratio = 1.92 [95% CI 1.32-2.80]). CONCLUSIONS: Pharyngolaryngectomy carries a high degree of risk of morbidity and mortality. Reconstructive failure worsens short- and long-term prognosis, and the use of cutaneous free flaps appears to improve survival.
[Mh] Termos MeSH primário: Neoplasias Hipofaríngeas/cirurgia
Neoplasias Laríngeas/cirurgia
Laringectomia/estatística & dados numéricos
Faringectomia/estatística & dados numéricos
[Mh] Termos MeSH secundário: Distribuição por Idade
Inglaterra/epidemiologia
Feminino
Seres Humanos
Neoplasias Hipofaríngeas/epidemiologia
Neoplasias Laríngeas/epidemiologia
Laringectomia/métodos
Masculino
Meia-Idade
Faringectomia/métodos
Complicações Pós-Operatórias/epidemiologia
Complicações Pós-Operatórias/etiologia
Retalhos Cirúrgicos
Resultado do Tratamento
Técnicas de Fechamento de Ferimentos/estatística & dados numéricos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1704
[Cu] Atualização por classe:171117
[Lr] Data última revisão:
171117
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170323
[St] Status:MEDLINE


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[PMID]:28205447
[Au] Autor:Sinha P; Pipkorn P; Zenga J; Haughey BH
[Ad] Endereço:1 Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri, USA.
[Ti] Título:The Hybrid Transoral-Pharyngotomy Approach to Oropharyngeal Carcinoma: Technique and Outcome.
[So] Source:Ann Otol Rhinol Laryngol;126(5):357-364, 2017 May.
[Is] ISSN:1943-572X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The indications, techniques, and outcomes for a minimally invasive surgical approach in oropharyngeal squamous cell carcinoma (OPSCC) unsuitable for transoral resection are not well-described. METHODS: A retrospective case series was performed using a prospectively assembled database of transoral surgery-treated OPSCC patients who also underwent a "hybrid" approach of combined transoral and limited pharyngotomy for tumor resection. Disease and functional outcomes were evaluated. RESULTS: Twenty patients underwent complete tumor resection using the hybrid approach. Median follow-up was 48 months. No postoperative pharyngocutaneous fistula occurred. One patient (5%) had a local recurrence. Kaplan-Meier estimates for disease-specific survival at 2 and 5 years were 94.4% (95% CI, 84%-100%) and 87% (95% CI, 70%-100%). All but 1 patient (due to chemoradiotherapy-related chondroradionecrosis) were decannulated, and 2 required long-term gastrostomy. CONCLUSION: In the absence of a favorable transoral access, the "hybrid" approach of combined transoral and limited pharyngotomy can accomplish margin-negative primary tumor resection, with a high degree of disease control and functional recovery in selected OPSCC patients.
[Mh] Termos MeSH primário: Carcinoma de Células Escamosas
Terapia a Laser
Procedimentos Cirúrgicos Minimamente Invasivos
Esvaziamento Cervical
Recidiva Local de Neoplasia/prevenção & controle
Neoplasias Orofaríngeas
Faringectomia
[Mh] Termos MeSH secundário: Idoso
Carcinoma de Células Escamosas/patologia
Carcinoma de Células Escamosas/cirurgia
Feminino
Seres Humanos
Terapia a Laser/efeitos adversos
Terapia a Laser/métodos
Masculino
Meia-Idade
Procedimentos Cirúrgicos Minimamente Invasivos/efeitos adversos
Procedimentos Cirúrgicos Minimamente Invasivos/métodos
Boca/cirurgia
Esvaziamento Cervical/efeitos adversos
Esvaziamento Cervical/métodos
Estadiamento de Neoplasias
Neoplasias Orofaríngeas/patologia
Neoplasias Orofaríngeas/cirurgia
Avaliação de Processos e Resultados (Cuidados de Saúde)
Faringectomia/efeitos adversos
Faringectomia/métodos
Faringe/diagnóstico por imagem
Faringe/cirurgia
Recuperação de Função Fisiológica
Estudos Retrospectivos
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170418
[Lr] Data última revisão:
170418
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170217
[St] Status:MEDLINE
[do] DOI:10.1177/0003489417691297


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[PMID]:28183429
[Au] Autor:Day AT; Genther DJ; Hui F; Mydlarz WK; Griffith G; Desai SC
[Ad] Endereço:Department of Otolaryngology, Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, MD.
[Ti] Título:Successful facial artery pseudoaneurysm coiling and pedicle preservation following free tissue transfer.
[So] Source:Am J Otolaryngol;38(1):103-107, 2017 Jan - Feb.
[Is] ISSN:1532-818X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Patients undergoing free tissue reconstruction are at risk for development of an anastomotic pseudoaneurysm, which may present as delayed neck hemorrhage or a pulsatile neck mass. Diagnosis may be achieved by noninvasive imaging, angiography, and exploration. Management strategies for head and neck pseudoaneurysms have included open vessel ligation, open direct vessel repair, endovascular parent vessel embolization, and, most recently, endovascular pseudoaneurysm embolization. In patients with anastomotic pseudoaneurysms where adequate flap inosculation is doubted, endovascular pseudoaneurysm embolization with pedicle preservation may be an appropriate primary treatment approach. We discuss the successful endovascular coiling of an external carotid artery branch anastomotic pseudoaneurysm in a patient one month after free tissue reconstruction of a total laryngopharyngectomy and partial glossectomy defect.
[Mh] Termos MeSH primário: Falso Aneurisma/terapia
Carcinoma de Células Escamosas/cirurgia
Retalhos de Tecido Biológico/transplante
Neoplasias Laríngeas/patologia
Neoplasias Laríngeas/cirurgia
Neoplasias da Língua/cirurgia
[Mh] Termos MeSH secundário: Idoso
Falso Aneurisma/diagnóstico por imagem
Falso Aneurisma/etiologia
Carcinoma de Células Escamosas/patologia
Artéria Carótida Externa/diagnóstico por imagem
Embolização Terapêutica/métodos
Seguimentos
Retalhos de Tecido Biológico/efeitos adversos
Glossectomia/métodos
Glote/patologia
Glote/cirurgia
Sobrevivência de Enxerto
Seres Humanos
Masculino
Faringectomia/métodos
Procedimentos Cirúrgicos Reconstrutivos/métodos
Medição de Risco
Fumar/efeitos adversos
Neoplasias da Língua/secundário
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170901
[Lr] Data última revisão:
170901
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170211
[St] Status:MEDLINE


  9 / 1168 MEDLINE  
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[PMID]:28054142
[Au] Autor:Kojima R; Tsukahara K; Motohashi R; Okada T; Yatomi M; Katsube Y; Takeda A; Agata A; Ogawa Y
[Ad] Endereço:Department of Otorhinolaryngology, Head and Neck Surgery, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan.
[Ti] Título:Extent of thyroid resection and thyroid function after postoperative radiotherapy following total laryngectomy or total pharyngo-laryngo-esophagectomy.
[So] Source:Int J Clin Oncol;22(3):438-441, 2017 Jun.
[Is] ISSN:1437-7772
[Cp] País de publicação:Japan
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: Concurrent chemoradiotherapy (CCRT) is often performed after total pharyngo-laryngo-esophagectomy (TPLE) or total laryngectomy (TL). Hypothyroidism is one of the side-effects of CCRT. The objective of this study was to ascertain the timing of onset and severity of latent hypothyroidism among patients who underwent radiotherapy (RT) or CCRT after TPLE or TL, using thyroid-stimulating hormone (TSH) as a biomarker, and to explore methods of preventing its development. METHODS: Participants comprised 21 patients who underwent these treatments at Tokyo Medical University Hachioji Medical Center between May 2009 and December 2013. TSH, free thyroxine 3, and free thyroxine 4 levels were used as indicators of thyroid function, and thyroid hormone was administered for TSH levels ≥15 µU/mL. RESULTS: Post-radiotherapeutic TSH levels in 17 of the 21 patients (81%) were not within the reference value, and 10 (48%) required thyroid hormone therapy. Pharmacotherapy was initiated within 1 year in 5 of these 10 patients (50%), and between 1 and 3 years in the remaining 5 patients. No patient who did not undergo thyroidectomy required hormone therapy. Early evaluation of thyroid function appears important when postoperative RT, including CCRT, is performed in combination with TPLE or TL. CONCLUSION: Our study suggested that postoperative CCRT or RT after TPLE or TL, especially hemithyroidectomy, carries a high risk for hypothyroidism.
[Mh] Termos MeSH primário: Quimiorradioterapia/efeitos adversos
Esofagectomia
Neoplasias Hipofaríngeas/terapia
Hipotireoidismo/etiologia
Neoplasias Laríngeas/terapia
Laringectomia
[Mh] Termos MeSH secundário: Idoso
Esofagectomia/efeitos adversos
Esofagectomia/métodos
Feminino
Seres Humanos
Neoplasias Hipofaríngeas/cirurgia
Hipotireoidismo/induzido quimicamente
Hipotireoidismo/tratamento farmacológico
Neoplasias Laríngeas/cirurgia
Laringectomia/efeitos adversos
Laringectomia/métodos
Masculino
Meia-Idade
Tratamentos com Preservação do Órgão/métodos
Faringectomia/efeitos adversos
Faringectomia/métodos
Período Pós-Operatório
Dosagem Radioterapêutica
Testes de Função Tireóidea
Tireoidectomia/efeitos adversos
Tireotropina/sangue
[Pt] Tipo de publicação:CLINICAL TRIAL; JOURNAL ARTICLE
[Nm] Nome de substância:
9002-71-5 (Thyrotropin)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:171013
[Lr] Data última revisão:
171013
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170106
[St] Status:MEDLINE
[do] DOI:10.1007/s10147-016-1082-x


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[PMID]:28011997
[Au] Autor:Hone RWA; Rahman E; Wong G; Annan Y; Alexander V; Al-Lami A; Varadharajan K; Parker M; Simo R; Pitkin L; Mace A; Ofo E; Balfour A; Nixon IJ
[Ad] Endereço:Faculty of Medical Science, Post Graduate Medical Institute, Anglia Ruskin University, Bishop Hall Lane, Chelmsford, Essex, UK. rwahone@doctors.org.uk.
[Ti] Título:Do salivary bypass tubes lower the incidence of pharyngocutaneous fistula following total laryngectomy? A retrospective analysis of predictive factors using multivariate analysis.
[So] Source:Eur Arch Otorhinolaryngol;274(4):1983-1991, 2017 Apr.
[Is] ISSN:1434-4726
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:Salivary bypass tubes (SBT) are increasingly used to prevent pharyngocutaneous fistula (PCF) following laryngectomy and pharyngolaryngectomy. There is minimal evidence as to their efficacy and literature is limited. The aim of the study was to determine if SBT prevent PCF. The study was a multicentre retrospective case control series (level of evidence 3b). Patients who underwent laryngectomy or pharyngolaryngectomy for cancer or following cancer treatment between 2011 and 2014 were included in the study. The primary outcome was development of a PCF. Other variables recorded were age, sex, prior radiotherapy or chemoradiotherapy, prior tracheostomy, type of procedure, concurrent neck dissection, use of flap reconstruction, use of prophylactic antibiotics, the suture material used for the anastomosis, tumour T stage, histological margins, day one post-operative haemoglobin and whether a salivary bypass tube was used. Univariate and multivariate analysis were performed. A total of 199 patients were included and 24 received salivary bypass tubes. Fistula rates were 8.3% in the SBT group (2/24) and 24.6% in the control group (43/175). This was not statistically significant on univariate (p value 0.115) or multivariate analysis (p value 0.076). In addition, no other co-variables were found to be significant. No group has proven a benefit of salivary bypass tubes on multivariate analysis. The study was limited by a small case group, variations in tube duration and subjects given a tube may have been identified as high risk of fistula. Further prospective studies are warranted prior to recommendation of salivary bypass tubes following laryngectomy.
[Mh] Termos MeSH primário: Anastomose Cirúrgica
Fístula Cutânea
Laringectomia
Doenças Faríngeas
Faringectomia
Complicações Pós-Operatórias/diagnóstico
Ductos Salivares/cirurgia
[Mh] Termos MeSH secundário: Idoso
Anastomose Cirúrgica/efeitos adversos
Anastomose Cirúrgica/métodos
Quimiorradioterapia/efeitos adversos
Fístula Cutânea/diagnóstico
Fístula Cutânea/epidemiologia
Fístula Cutânea/etiologia
Feminino
Seres Humanos
Incidência
Neoplasias Laríngeas/cirurgia
Laringectomia/efeitos adversos
Laringectomia/métodos
Masculino
Meia-Idade
Avaliação de Processos e Resultados (Cuidados de Saúde)
Doenças Faríngeas/diagnóstico
Doenças Faríngeas/epidemiologia
Doenças Faríngeas/etiologia
Faringectomia/efeitos adversos
Faringectomia/métodos
Prognóstico
Estudos Prospectivos
Estudos Retrospectivos
Reino Unido/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170512
[Lr] Data última revisão:
170512
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161225
[St] Status:MEDLINE
[do] DOI:10.1007/s00405-016-4391-9



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