{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T11:18:04Z","timestamp":1787829484323,"version":"build-2784847793"},"reference-count":27,"publisher":"Index Copernicus","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Otolaryngol Pol"],"published-print":{"date-parts":[[2026,5,25]]},"abstract":"<ns3:p>&lt;p&gt;&lt;strong&gt;Introduction: &lt;\/strong&gt;Total laryngectomy (TL) remains the standard treatment for advanced la\u2011 ryngeal cancer, and its perioperative management requires close collaboration within a multidisciplinary team, including anaesthesiologists and clinical nutritionists.&lt;\/p&gt;&lt;p&gt;&lt;strong&gt;Aim:&lt;\/strong&gt; The aim of this study was to analyse the perioperative course of patients un\u2011 dergoing TL from both an anaesthesiologist\u2019s and a nutritionist\u2019s perspective, with a particular focus on the feasibility and performance of structured data extraction from electronic medical records using large language models (LLMs).&lt;\/p&gt;&lt;p&gt;&lt;strong&gt;Material and methods:&lt;\/strong&gt; We performed a single\u2011centre retrospective analysis of 43 consecutive patients undergoing TL (ICD\u20119 codes 30.32, 30.39, 30.41, 30.49) be\u2011 tween January 2024 and April 2026. Clinical data, including physician notes (n = 845), nursing notes (n = 2578), discharge summaries (n = 173), and consultations (n = 123), were subjected to structured extraction using large language models (gemma-3-31Bit\/gemma-4-26B-it). Demographics, tumour stage, length of stay (LOS), periopera\u2011 tive nutrition, pharmacotherapy, postoperative complications, temporal laboratory trends, and rehabilitation were analysed.&lt;\/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;\/strong&gt;The cohort comprised 35 men (81%) and 8 women (19%), with a mean age of 66.4 9.8 years; pT4a (49%) and pN0 (82%) predominated. Median LOS was 15.0 days (IQR 13.1\u201316.5). Enteral nutrition via nasogastric tube was used in 95% of patients, and oral intake was initiated at a median of postoperative day 13. Multimodal anal\u2011 gesia based on intravenous paracetamol (60%), ketoprofen (47%), and metamizole (40%) was routinely employed, while strong opioids were used in only 5% of pa\u2011 tients. Postoperative complications occurred in 22.5% of cases, with pharyngocuta\u2011 neous fistula (PCF) being the most frequent (12.5%). In\u2011hospital mortality was 0%, and overall mortality during a median 12\u2011month follow\u2011up was 2.3%. CRP peaked on postoperative day 3 (mean 114 mg\/L). Pharmacologic VTE prophylaxis was admi\u2011 nistered in 65% of patients.&lt;\/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions:&lt;\/strong&gt; In TL patients, enteral feeding forms the backbone of nutritional sup\u2011port, and multimodal analgesia provides effective pain control, whereas VTE pro\u2011phylaxis and other modifiable elements of perioperative care warrant optimization within prehabilitation and ERAS-based protocols.&lt;\/p&gt;&lt;p&gt;&amp;nbsp;&lt;\/p&gt;<\/ns3:p>","DOI":"10.5604\/01.3001.0055.7302","type":"journal-article","created":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T06:13:40Z","timestamp":1779689620000},"page":"36-42","source":"Crossref","is-referenced-by-count":0,"title":["Leveraging large language models to audit perioperative total laryngectomy care: anesthetic, nutritional, and complication profiles in a real\u2011world cohort"],"prefix":"10.5604","volume":"80","author":[{"given":"Bernard","family":"Zaj\u0105c","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Intensive Care, Regional Specialist Hospital in Wroclaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0006-6352","authenticated-orcid":false,"given":"Ma\u0142gorzata","family":"Wierzbicka","sequence":"additional","affiliation":[{"name":"Department of Clinical Surgical Sciences, Faculty of Medicine, Wroclaw University of Science and Technology, Wroclaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mateusz","family":"Jeziorny","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Regional Specialist Hospital in Wroclaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Klara","family":"Zalewska","sequence":"additional","affiliation":[{"name":"Biobank Research Group and Section of the Biobank Medical Facility, \u0141ukasiewicz Network - PORT Polish Center for Technology Development, Poland, Research and Development Centre, Regional Specialist Hospital in Wroclaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalia","family":"J\u0119druchniewicz","sequence":"additional","affiliation":[{"name":"Research and Development Centre, Regional Specialist Hospital in Wroclaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3689","reference":[{"key":"638459r1","unstructured":"Wojciechowska U., Didkowska J., Zachorowania i zgony na nowotwory z\u0142o\u015bli\u2011we w Polsce. 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