Postoperative Complications after total Laryngectomy: An Analysis of 148 Patients

Introduction The total laryngectomy is one of the biggest and most challenging procedures in otolaryngology. Extensive research in the past has discovered several risk factors for postoperative complications. Several studies have proposed the Clavien-Dindo classification (CDC) as a solution to classifying postoperative complications into five grades from less severe to severe.

The goal of our study was to research whether postoperative complications after total laryngectomy can be classified according to the CDC.

Methods All patients (n = 148) that underwent a total laryngectomy after diagnosis of SCC at the Charité in Berlin Germany between 2010 and 2019 were included. We reviewed the electronic patient files for risk factors and postoperative complications according to the CDC.

A logistic regression analysis of all risk factors was performed by grouping patients into severe postoperative complications (CDC≥ 4) and less severe complications.

Results Out of the eleven risk factors, only the Charlson Comorbidity Index (CCI) for postoperative complications was significant (p<0.0001). A one point increase in the CCI led to a 1.9 fold increased risk of experiencing a severe postoperative complication. The other risk factors did not achieve statistical significance within this study population.

Discussion To our knowledge this study included the largest number of patients for which postoperative complications have been classified according to the CDC. We concur with results of previous studies using the CDC as a classification tool for postoperative complications.Our results show that the CCI can be used as a classification system for screening patients with a high risk for postoperative complications.

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Publication History

Article published online:
10 June 2020