Analysis of Pepsin in Patients with Tracheoesophageal Fistula and Voice Prosthesis Complications (CROSBI ID 582345)
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Đanić-Hadžibegović, Ana ; Đanić, Davorin ; Tićac, Robert ; Kozmar A.
engleski
Analysis of Pepsin in Patients with Tracheoesophageal Fistula and Voice Prosthesis Complications
The aim of this 1-year prospective study was to investigate the relationship between pepsin concentration in sputum and the occurrence of tracheoesophageal fistula (TEF) complications and voice prosthesis (VP) complications, after total laryngectomy and VP implantation. We assessed the concentrations of pepsin in the sputum of 41 laryngectomized patients and correlated it with the incidence of TEF complications (periprostethic leakage, atrophy, esophageal mucosa hypertrophy, granulations, fistula enlargement, and VP dislocation), VP complications (transprosthetic leakage, Candida infection) and voice quality. Pepsin levels were measured by enzyme-linked immunoadsorbent assay (ELISA). Voice quality was assessed by Harrison- Robilard - Schultz (HRS) scale. In all, 17 (42%) patients had complications. All of them had TEF complications, whereas VP complication, together with TEF was found in 9 (22%) patients. We found no significant correlation between adjuvant radiotherapy and TEF complications. Most of patients, 33 (80%), had positive pepsin level in sputum. Median value of pepsin concentration in all patients was 4.8 (range 81.7). Median pepsin concentration was higher in patients free of TEF or VP complications (3.2, range 19.3 vs 6.6, range 81.7) but that difference was not statistically significant (Mann-Whitney test, Z -1, 562, p=0, 118). We found statistically insignificant negative correlation between pepsin levels and voice quality measured by HRS scale (Spearman’s rho, p>0.05). Although reflux was proposed as cause of TEP complications and pepsin has been proven as a most sensitive and specific marker of ekstraesophageal reflux, we did not find any statistically significant correlation between pepsin levels and occurrence of TEF or VP complications.
tracheoesophageal fistula ; reflux ; pepsin ; laryngectomy
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Podaci o prilogu
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Podaci o skupu
International Congress on Head and Neck Tumors
predavanje
20.10.2011-22.10.2011
Zagreb, Hrvatska