Risk factors for tracheal necrosis after total pharyngolaryngectomy

BackgroundTracheal necrosis is a severe complication of total pharyngolaryngectomy (TPL). The purpose of this retrospective study was to identify risk factors for tracheal necrosis after TPL. MethodsWe performed a retrospective chart review of 177 patients who had undergone TPL. The preoperative, operative, and postoperative variables were examined, and possible risk factors for tracheal necrosis were subjected to univariate analysis and multivariate logistic regression. ResultsTracheal necrosis occurred in 35 patients (19.8%), and tracheoesophageal fistula subsequently developed in 3 of these patients. Multivariate logistic regression analysis identified total esophagectomy and diabetes mellitus as significant risk factors for tracheal necrosis after TPL. ConclusionThe findings of this study will be useful for assessing the risk of tracheal necrosis after TPL. In patients at high risk for tracheal necrosis, efforts should be made to preserve the tracheal circulation and to prevent life-threatening sequelae if tracheal necrosis occurs. (c) 2014 Wiley Periodicals, Inc. Head Neck37: 1207-1210, 2015