Stomal recurrence post laryngectomy in University College Hospital, Ibadan.

Abstract

The outcome of laryngeal carcinoma is favourable and cure rate high if detected early. A major complication experienced post surgery for advanced laryngeal carcinoma is recurrence especially at the tracheostome. This study aimed at evaluat ing the incidence of stomal recurrence post total laryngec tomy with respect to the risk factors. This is a retrospective review of eighteen patients (14 males and 4 females) that had total lary ngectomy for histologically confirmed laryngeal car cinoma from 1990-2002. Seven patients (38.9%) had stomal recurrence. Seven patients (38.9%) had palpable deep cervical nodes at presentation. Fourteen (77.8%) and four (22.2%) pa tients had emergency and elective tracheostomy procedures respectively. Twelve patients (66.67%) had neck node dissec tion during surgery. Post-opcratively, twelve patients (66.7%) had only radical radiotherapy; four (22.2%) had both radio-/ chemotherapy while two had preoperative and additional post operative radiotherapy. The mean duration between the pre operative tracheostomy and total laryngectomy was 62.19 ± 64.56 days while the mean duration between total laryngec tomy and development of stomal recurrence was 7.79 ± 8.57 months. Ten patients (55.6%) died, (seven with and three with out stomal recurrence but who died of distant metastases to the lungs and thoracolumbar vertebral bodies). Stomal recur rence post laryngectomy has a grave prognosis. This present study also showed that advanced stage 3 and 4 tumour, transglottic involvement and the presence of preoperative tra cheostomy are the likely risk factors that could be associated with recurrence in our environment. There is therefore the need to reevaluate these preventive measures in a prospec tive study in order to improve the final outcome in our envi ronment.