The localisation of primary tracheoesophagealshunt during a Laryng(pharyn)gectomy (LPE) determines the risk of a hospital required shunt insufficiency treatment

Introduction:

Tracheoesophageal shunt insufficiency is a common problem for patients who have received a LPE. As a result, we investigated if a tracheoesophageal shunt insufficiency could be the result of a specific operational technique, and if other risk factors are responsible.

Materials and Methods:

A monocentric, retrospective cohort analysis of 171 patients who underwent a LPE from 2004 – 2014 was performed. Patients with a secondary prosthesis operation as well as patients who never received a barium swallow and/or postoperative imaging were excluded.

Results:

A large proportion of LPE patients developed a hospital required shunt insufficiency treatment. Approximately 2/3 of patients were who were treated successfully in the long term. The localization of the provox prosthesis by primary TES insertion during the LPE affected the risk of a hospital required shunt insufficiency treatment. The adjuvant radiotherapy has no direct risk in the development of a tracheoesophageal insufficiency.

Conclusion:

Secondary TES operation should be performed if a deep LPE is undertaken, as this would allow a wider margin between the Manubrium sterni and the TES, hereby lowering the risk of a TES insufficiency.

Publication History

Publication Date:
18 April 2018 (online)