Öz
Aim: Larynx and pulmonary malignancies can be seen synchronously or metachronously as a result of common etiological factors. In this study, we aimed to present our clinical approach and management methods of these patients.
Materials and Methods: The records of patients underwent pulmonary resection with previous larynx malignancy between January 2010 and April 2016 were investigated retrospectively.
Results: All of 20 patients were male with a mean age of 62.18 ± 2.65 years (range 47 to 84 years). Synchronous larynx and pulmonary malignancies without any previous treatment for larynx malignancy were defined as Group 1 (6 patients) and pulmonary malignancy patients with previous treated larynx malignancy were defined as Group 2 (14 patients). Tracheostomy had been performed to four patients in Group 2. The pre, -per and postoperative problems and complications were as follows: Four (20%) patients could not performed pulmonary function test (PFT), single lung ventilation could not be obtained in 3 (15%) patients, differential diagnosis could not be achieved in frozen section examination in 4 of 9 (44.4%) patients.
Conclusion: The patients with both larynx and pulmonary malignancies must be evaluated carefully in terms of entubation difficulties. Arterial blood gas analysis with exercise test and six minutes walk test must be performed to the patients who cannot perform PFT. Humidification of the respiration air, bronchoscopy and tracheostomy when needed must be kept in mind to avoid postoperative secretion retention.
Anahtar Kelimeler
Larynx and pulmonary malignancy tracheostomy entubation difficulty
Kaynakça
- Bertrand D, Righini C, Ferretti G, Brambilla C, Moro-Sibilot D. Early diagnosis of bronchial carcinoma after head and neck cancer. Rev Mal Respir 2008;25(5):559-68.
- Rennemo E, Zätterström U, Boysen M. Impact of second primary tumors on survival in head and neck cancer: An analysis of 2,063 cases. Laryngoscope 2008;118(8):1350-6.
- Griffioen GH, Louie AV, De Bree R, et al. Second primary lung cancers following a diagnosis of primary head and neck cancer. Lung Cancer 2015;88(1):94-9.
- Ding N, Zhou N, Zhou M, Ren GM. Respiratory cancers and pollution. Eur Rev Med Pharmacol Sci 2015;19(1):31-7.
- Ellis L, Coleman MP, Rachet B. The impact of life tables adjusted for smoking on the socio-economic difference in net survival for laryngeal and lung cancer. Br J Cancer 2014;8(1):195-202.
- Overstreet S, Parekh KR, Gross TJ. Cardiopulmonary exercise testing after laryngectomy: A connection conundrum. Respir Med Case Rep 2015;12(16):11-4.
- Hess M.M, Schwenk R.A, Frank W, Loddenkemper R. Pulmonary function after total laryngectomy. Laryngoscope 1999;109(9):988-94.
- Toman H, Şahin H, Kiraz HA, Ömür D, Erbaş M. Trakeostomisi olan bir hastada çift lümenli tüp ile tek akciğer ventilasyonu. GKDA Derg 2013;19(1):49-50.
- Choi WA, Park JH, Kim DH, Kang SW. Cough assistance device for patients with glottis dysfunction and/or tracheostomy. J Rehabil Med 2012;44(4):351-4.
- Gao Y, Wang L, Zhang D. Second primary lung cancer in laryngeal cancer patients: Report on 36 cases. Zhonghua Zhong Liu Za Zhi 2001;23(4):341-3.
- Shih CK, Kuo YW, Lu IC, Hsu HT, Chu KS, Wang FY. Application of a double-lumen tube for one-lung ventilation in patients with anticipated difficult airway. Acta Anaesthesiol Taiwan 2010;48(1):41-4.
- Neustein SM. The use of bronchial blockers for providing one-lung ventilation. J Cardiothorac Vasc Anesth 2009;23(6):860-8.
- Vretzakis G, Theodorou E, Mikroulis D. Endobrochial blockade through a tracheostomy tube for lung isolation. Anesth Analg 2008;107(5):1644-5.
- Yaney LL. Double-lumen endotracheal tube for one-lung ventilation through a fresh tracheostomy stoma: A case report. AANA J 2007;75(6):411-5.
- Lim HK, Ahn HS, Byon HJ, Lee MH, Cha YD. Clinical experience of one lung ventilation using an endobronchial blocker in a patient with permanent tracheostomy after total laryngectomy. Korean J Anesthesiol 2013;64(4):386-7.
- Masamune T, Matsukawa T, Ookawa I, Sasuga M, Tamaki F, Kumazawa T. Double-lumen tracheostomy tube (Tracheopart) used in two patients for one-lung ventilation. Masui 2004;53(12):1418-20.
- Tan AK. Incentive spirometry for tracheostomy and laryngectomy patients. J Otolaryngol 1995;24(5):292-4.
- Lorenz KJ, Maier H. Pulmonary rehabilitation after total laryngectomy using a heat and moisture exchanger (HME). Laryngorhinootologie 2009;88(8):513-22.
- Lee SC, Park JH, Kang SW, Kim DH, Song SH. External control of exhalation for cough assistance: A method for patients with glottis dysfunction and/ortracheostomy. Arch Phys Med Rehabil 2009;90(8):1402-7.
Öz
Gereç ve Yöntem: Kliniğimizde Ocak 2010 – Nisan 2016 yılları arasında, öncesinde larinks malignitesi tanısı alan ve akciğerde lezyon sebebi ile cerrahi uygulanan hastalar retrospektrif olarak incelendi. Bulgular: Çalışmaya dahil edilen, tamamı erkek 20 hastanın yaş ortalaması 62.18 ± 2.65 (47-84) idi. Larinks malignitesi ile eş zamanlı olarak akciğerde lezyon saptanan ve henüz larinks malignitesine yönelik hiçbir tedavi almamış olan hastalar Grup 1 (6 hasta), larinks malignitesine yönelik tedavilerini almakta olan veya tamamlayan, izlemde akciğer lezyonu saptanan hastalar ise Grup 2 (14 hasta) olarak tanımlandı. Grup 2’deki hastalardan dördünde trakeostomi mevcuttu. Hastaların dördüne (%20) solunum fonksiyon testi (SFT) yapılamadı, üç hastada (%15) tek akciğer ventilasyonunun sağlanamadı, yapılan dokuz frozen-section incelemeden dördünde (%44.4) tanı elde edilemedi ve üç hastada (%15) sekresyon retansiyonu gelişti. Sonuç: Larinks ve akciğer malignitesi bir arada bulunan hastaların operasyon öncesi entübasyon zorluğu açısından dikkatlice incelenmesi gerekir. SFT uygulanamayan hastaların preoperatif eforlu arteriyel kan gazı, altı dakika yürüme testi gibi yöntemlerle değerlendirilmelidir. Postoperatif sekresyon retansiyonuna yönelik solunum havasının nemlendirilmesi, bronkoskopi ve gereğinde trakeostomi açılması akılda tutulmalıdır.
Anahtar Kelimeler
Larinks ve akciğer malignitesi trakeostomi entübasyon güçlüğü
Kaynakça
- Bertrand D, Righini C, Ferretti G, Brambilla C, Moro-Sibilot D. Early diagnosis of bronchial carcinoma after head and neck cancer. Rev Mal Respir 2008;25(5):559-68.
- Rennemo E, Zätterström U, Boysen M. Impact of second primary tumors on survival in head and neck cancer: An analysis of 2,063 cases. Laryngoscope 2008;118(8):1350-6.
- Griffioen GH, Louie AV, De Bree R, et al. Second primary lung cancers following a diagnosis of primary head and neck cancer. Lung Cancer 2015;88(1):94-9.
- Ding N, Zhou N, Zhou M, Ren GM. Respiratory cancers and pollution. Eur Rev Med Pharmacol Sci 2015;19(1):31-7.
- Ellis L, Coleman MP, Rachet B. The impact of life tables adjusted for smoking on the socio-economic difference in net survival for laryngeal and lung cancer. Br J Cancer 2014;8(1):195-202.
- Overstreet S, Parekh KR, Gross TJ. Cardiopulmonary exercise testing after laryngectomy: A connection conundrum. Respir Med Case Rep 2015;12(16):11-4.
- Hess M.M, Schwenk R.A, Frank W, Loddenkemper R. Pulmonary function after total laryngectomy. Laryngoscope 1999;109(9):988-94.
- Toman H, Şahin H, Kiraz HA, Ömür D, Erbaş M. Trakeostomisi olan bir hastada çift lümenli tüp ile tek akciğer ventilasyonu. GKDA Derg 2013;19(1):49-50.
- Choi WA, Park JH, Kim DH, Kang SW. Cough assistance device for patients with glottis dysfunction and/or tracheostomy. J Rehabil Med 2012;44(4):351-4.
- Gao Y, Wang L, Zhang D. Second primary lung cancer in laryngeal cancer patients: Report on 36 cases. Zhonghua Zhong Liu Za Zhi 2001;23(4):341-3.
- Shih CK, Kuo YW, Lu IC, Hsu HT, Chu KS, Wang FY. Application of a double-lumen tube for one-lung ventilation in patients with anticipated difficult airway. Acta Anaesthesiol Taiwan 2010;48(1):41-4.
- Neustein SM. The use of bronchial blockers for providing one-lung ventilation. J Cardiothorac Vasc Anesth 2009;23(6):860-8.
- Vretzakis G, Theodorou E, Mikroulis D. Endobrochial blockade through a tracheostomy tube for lung isolation. Anesth Analg 2008;107(5):1644-5.
- Yaney LL. Double-lumen endotracheal tube for one-lung ventilation through a fresh tracheostomy stoma: A case report. AANA J 2007;75(6):411-5.
- Lim HK, Ahn HS, Byon HJ, Lee MH, Cha YD. Clinical experience of one lung ventilation using an endobronchial blocker in a patient with permanent tracheostomy after total laryngectomy. Korean J Anesthesiol 2013;64(4):386-7.
- Masamune T, Matsukawa T, Ookawa I, Sasuga M, Tamaki F, Kumazawa T. Double-lumen tracheostomy tube (Tracheopart) used in two patients for one-lung ventilation. Masui 2004;53(12):1418-20.
- Tan AK. Incentive spirometry for tracheostomy and laryngectomy patients. J Otolaryngol 1995;24(5):292-4.
- Lorenz KJ, Maier H. Pulmonary rehabilitation after total laryngectomy using a heat and moisture exchanger (HME). Laryngorhinootologie 2009;88(8):513-22.
- Lee SC, Park JH, Kang SW, Kim DH, Song SH. External control of exhalation for cough assistance: A method for patients with glottis dysfunction and/ortracheostomy. Arch Phys Med Rehabil 2009;90(8):1402-7.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Araştırma Makaleleri |
| Yazarlar | |
| Yayımlanma Tarihi | 1 Aralık 2017 |
| Gönderilme Tarihi | 19 Ağustos 2016 |
| Yayımlandığı Sayı | Yıl 2017 |