1. Examine the national rates of complications, readmission, reoperation, death and length of hospital stay after laryngectomy.
2. Explore the risks of neck dissection with laryngectomy using outcomes.
Study Design: retrospective review of the American College of Surgeons National Quality Improvement Program (ACS-NSQIP) database
Setting: Multicenter data pooled from 2005-2013 ACS-NSQIP database.
Methods: The database was analyzed for patients undergoing laryngectomy with and without neck dissection. Demographic, perioperative complication, reoperation, readmission, and death variables were analyzed.
Results: Our study found 754 patients who underwent total laryngectomy during this time. Demographic analysis showed average age was 63 yrs old, most [555 (75%)] were white, and most [598 (79%)] were male. Of these patients, 520(69%) included a neck dissection while 234(31%) did not. When comparing patients who received a neck dissection to those who did not, there were no significant differences in median length of hospital stay (12.5 days w/ ND vs. 13.3 days w/o ND p=0.99), rates of complication (40% w/ ND vs. 35% w/o ND p=0.23), reoperation (13.5% w/ ND vs. 14% w/o ND p=0.81), readmission (14% w/ ND vs. 18% w/o ND p=0.27), and death (1.3% w/ ND vs. 1.3% w/o ND p>0.99). Furthermore, neck dissection did not increase the risk of complication (p=0.23), readmission (p=0.27), reoperation (p=0.81), death (p=0.94), or lengthened hospital stay (p=0.38).
Conclusion: Concurrent neck dissection does not increase postoperative morbidity or mortality in patients undergoing total laryngectomies. These results may help physicians make decisions regarding concurrent neck dissection with total laryngectomy.