Our Summary

This study looked at whether the number of laryngectomies (surgery to remove the voice box due to cancer) a surgeon performs affects the patient’s risk of complications or death. The researchers used a massive dataset to look at over 45,000 laryngectomy procedures done between 2001 and 2011.

They found that surgeons who perform more than five laryngectomies per year have patients with lower rates of medical and surgical complications. This effect was even more pronounced for surgeons performing more than nine laryngectomies per year, who had significantly lower rates of in-hospital death and acute medical complications.

The study also found that these high-volume surgeons were more likely to work in large, teaching, nonprofit hospitals, and were more likely to treat white patients, patients with private insurance, and patients with less severe illnesses.

In conclusion, the more laryngectomies a surgeon performs (i.e. higher surgeon volume), the better the patient outcomes. This finding suggests that the number of procedures a surgeon performs is a key factor in the success of the hospital overall.

FAQs

  1. Does the number of laryngectomies a surgeon performs impact the risk of complications or death for the patient?
  2. Is there a significant difference in patient outcomes between surgeons who perform more than five laryngectomies per year and those who perform more than nine?
  3. What type of hospitals and patients are high-volume laryngectomy surgeons more likely to work with?

Doctor’s Tip

Based on this research, a doctor might advise a patient undergoing a laryngectomy to seek out a surgeon who has experience and performs a high volume of these procedures. This can help decrease the risk of complications and improve overall outcomes. It is important for patients to ask their healthcare provider about the surgeon’s experience and volume of laryngectomies before undergoing the procedure.

Suitable For

Patients who are typically recommended for laryngectomy surgery are those with advanced laryngeal cancer that has not responded to other treatments such as radiation or chemotherapy. Additionally, patients with recurrent laryngeal cancer, severe vocal cord dysfunction, or other conditions that significantly affect their ability to breathe or speak may also be recommended for laryngectomy. Ultimately, the decision to undergo laryngectomy is made on a case-by-case basis by a multidisciplinary team of healthcare professionals, taking into consideration the patient’s overall health and treatment goals.

Timeline

Before laryngectomy:

  • Patient is diagnosed with cancer of the larynx
  • Patient undergoes various tests and consultations to determine the best course of treatment
  • Patient may undergo chemotherapy and/or radiation therapy to shrink the tumor
  • Patient meets with a surgeon to discuss the possibility of laryngectomy

After laryngectomy:

  • Patient undergoes surgery to remove the voice box
  • Patient may need a temporary or permanent tracheostomy to help with breathing
  • Patient undergoes speech therapy to learn how to communicate without a voice box
  • Patient may need additional treatments such as radiation therapy or chemotherapy
  • Patient may experience physical and emotional challenges, such as difficulty swallowing, changes in appearance, and adjusting to life without a voice box

Overall, the patient’s journey before and after laryngectomy involves a combination of medical treatments, surgical procedures, rehabilitation, and emotional support to help them adjust to their new way of life.

What to Ask Your Doctor

  1. How many laryngectomies do you perform each year?
  2. What is your experience with laryngectomy surgery?
  3. What are the potential complications of laryngectomy surgery?
  4. What is the success rate of laryngectomy surgery in terms of removing cancer?
  5. What is the recovery process like after laryngectomy surgery?
  6. Are there any alternative treatments to laryngectomy that I should consider?
  7. Will I need speech therapy after laryngectomy surgery?
  8. How will laryngectomy surgery affect my ability to speak, swallow, and breathe?
  9. What follow-up care will be needed after laryngectomy surgery?
  10. Are there any support groups or resources available for laryngectomy patients?

Reference

Authors: Saraswathula A, Austin JM, Fakhry C, Vosler PS, Mandal R, Koch WM, Tan M, Eisele DW, Frick KD, Gourin CG. Journal: Laryngoscope. 2023 Apr;133(4):834-840. doi: 10.1002/lary.30229. Epub 2022 May 30. PMID: 35634691