TY - JOUR
T1 - Postoperative mechanical bowel obstruction after pharyngolaryngectomy for hypopharyngeal cancer
T2 - Retrospective analysis using a Japanese inpatient database
AU - Suzuki, Sayaka
AU - Yasunaga, Hideo
AU - Matsui, Hiroki
AU - Fushimi, Kiyohide
AU - Ando, Mizuo
AU - Yamasoba, Tatsuya
N1 - Funding Information:
This work was supported by grants from the Ministry of Health, Labor, and Welfare, the Japan (H29-Policy- Designated-009 and H29-ICT-General- 004); Ministry of Education, Culture, Sports, Science, and Technology, Japan (17H04141); and the Japan Agency for Medical Research and Development (AMED). The funders had no role in the execution of this study or the interpretation of its results
Funding Information:
The authors thank Dr Yusuke Sasabuchi, Department of Health Services Research, Graduate School of Medicine, The University of Tokyo, for his assistance in confirming the accuracy of the surgical classification.
Publisher Copyright:
© 2018 Wiley Periodicals, Inc.
PY - 2018/7
Y1 - 2018/7
N2 - Background: Data have been limited on donor-site mechanical bowel obstruction after pharyngolaryngectomy with free jejunum graft reconstruction. Methods: Using a nationwide Japanese inpatient database, we extracted data on patients who underwent pharyngolaryngectomy for hypopharyngeal cancer between July 2007 and March 2014. A Cox proportional hazard model was used to determine the association between background characteristics and the occurrence of mechanical bowel obstruction. Results: Among the 3320 eligible patients from 332 hospitals, 108 patients (3.3%) developed mechanical bowel obstruction after a median 88 (interquartile range 26-217) postoperative days. Multivariable Cox regression analysis revealed that older age (≥60 years old) was independently associated with an increased risk of mechanical bowel obstruction, whereas sex, body mass index [BMI], smoking status, comorbidity at admission, blood transfusion, history of surgery, and hospital type were not. Conclusion: In pharyngolaryngectomy, careful attention should be paid to the risk of abdominal complications and, thus, to the graft choice, especially in elderly patients.
AB - Background: Data have been limited on donor-site mechanical bowel obstruction after pharyngolaryngectomy with free jejunum graft reconstruction. Methods: Using a nationwide Japanese inpatient database, we extracted data on patients who underwent pharyngolaryngectomy for hypopharyngeal cancer between July 2007 and March 2014. A Cox proportional hazard model was used to determine the association between background characteristics and the occurrence of mechanical bowel obstruction. Results: Among the 3320 eligible patients from 332 hospitals, 108 patients (3.3%) developed mechanical bowel obstruction after a median 88 (interquartile range 26-217) postoperative days. Multivariable Cox regression analysis revealed that older age (≥60 years old) was independently associated with an increased risk of mechanical bowel obstruction, whereas sex, body mass index [BMI], smoking status, comorbidity at admission, blood transfusion, history of surgery, and hospital type were not. Conclusion: In pharyngolaryngectomy, careful attention should be paid to the risk of abdominal complications and, thus, to the graft choice, especially in elderly patients.
KW - donor-site abdominal complications
KW - free jejunal flap reconstruction
KW - Japanese national inpatient database
KW - pharyngolaryngectomy
KW - risk factors
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U2 - 10.1002/hed.25139
DO - 10.1002/hed.25139
M3 - Article
C2 - 29537633
AN - SCOPUS:85043680824
SN - 1043-3074
VL - 40
SP - 1548
EP - 1554
JO - Head and Neck
JF - Head and Neck
IS - 7
ER -
