{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T18:14:05Z","timestamp":1791656045675,"version":"4.3.4"},"reference-count":42,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2016,12,27]],"date-time":"2016-12-27T00:00:00Z","timestamp":1482796800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2017,5,15]]},"abstract":"<jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>The purpose of this study was to describe the 30\u2010day incidence of complications after total laryngectomy (TL) in a high\u2010volume institution and their impact on the hospital length of stay (LOS) and readmission rates.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>A retrospective cohort study of all patients who underwent TL at The University of Texas MD Anderson Cancer Center from January 1, 2010 through June 30, 2013 was conducted. The patient demographics, treatment history, LOS, and 30\u2010day post\u2010TL complications and readmissions were extracted from the medical record. Univariate associations were analyzed, and stepwise backward selection methods were used to fit multivariate models.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>Two hundred forty\u2010five patients were included. Complications occurred in 83 patients (33.9%) and included 3 deaths (1.2%). Wound complications occurred in 53 patients (21.6%), and 34 were pharyngocutaneous fistulas (PCFs; 13.9% overall). Thirty\u2010four patients (13.9%) were readmitted within 30 days. A multivariate analysis revealed the following: wound complications were associated with former (odds ratio [OR], 5.1; <jats:italic>P<\/jats:italic>\u2009=\u2009.03) and current smokers (OR, 5.8; <jats:italic>P<\/jats:italic>\u2009=\u2009.02), PCFs were associated with prior wide\u2010field radiation (OR, 3.1; <jats:italic>P<\/jats:italic>\u2009=\u2009.01) but not prior narrow\u2010field (larynx\u2010only) radiation (OR, 1.4; <jats:italic>P<\/jats:italic>\u2009=\u2009.61), LOS was associated with the type of flap (<jats:italic>P<\/jats:italic>\u2009=\u2009.002) and postoperative hematomas (<jats:italic>P<\/jats:italic>\u2009=\u2009.05), and readmissions were associated with preoperative hypoalbuminemia (<jats:italic>P<\/jats:italic>\u2009=\u2009.003) and postoperative wound complications (<jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>Complications occurred in approximately one\u2010third of TL patients and particularly in patients with poor wound\u2010healing risk factors such as prior smoking and radiation. As expected, LOS was longer among reconstructed patients. Readmission was associated with hypoalbuminemia and postoperative wound complications. These data can inform quality improvement efforts and the counseling of high\u2010risk patients undergoing TL. <jats:bold><jats:italic>Cancer<\/jats:italic> 2017;123:1760\u20131767<\/jats:bold>. \u00a9 <jats:italic>2016 American Cancer Society<\/jats:italic>.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.30483","type":"journal-article","created":{"date-parts":[[2016,12,27]],"date-time":"2016-12-27T09:53:44Z","timestamp":1482832424000},"page":"1760-1767","source":"Crossref","is-referenced-by-count":89,"title":["Complications, hospital length of stay, and readmission after total laryngectomy"],"prefix":"10.1002","volume":"123","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3291-841X","authenticated-orcid":false,"given":"Ryan. P.","family":"Goepfert","sequence":"first","affiliation":[{"name":"Department of Head and Neck Surgery The University of Texas MD Anderson Cancer Center Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine A.","family":"Hutcheson","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery The University of Texas MD Anderson Cancer Center Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan S.","family":"Lewin","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery The University of Texas MD Anderson Cancer Center Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neha G.","family":"Desai","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery The University of Texas MD Anderson Cancer Center Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark E.","family":"Zafereo","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery The University of Texas MD Anderson Cancer Center Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy C.","family":"Hessel","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery The University of Texas MD Anderson Cancer Center Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carol M.","family":"Lewis","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery The University of Texas MD Anderson Cancer Center Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Randal S.","family":"Weber","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery The University of Texas MD Anderson Cancer Center Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neil 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