Incidence, Severity, and Risk Factors of Early Postoperative Complications in Laryngectomy Patients: A Retrospective Analysis

Purpose To determine the incidence, severity and risk factors of complications in patients undergoing laryngectomy. Methods 433 patients with hypopharyngeal and laryngeal carcinomas who underwent laryngectomies from February 2023 to October 2023 were enrolled in this retrospective study. Clinical data of the patients were collected according to the Electronic Medical Record System, including data of demographic and clinical characteristics, surgical treatment, laboratory test, complications within 30 days following laryngectomy. Risk factors for early postoperative complications were identified with univariate and multivariate logistic regression analysis. Results Early postoperative complications occurred in 19.4% of patients following laryngectomy. In partial laryngectomies, subcutaneous emphysema was the predominant issue, affecting 12.0% of patients (n = 33). Among the potential postoperative complications of total laryngecromy, wound infection and pharyngocutaneous fistula stand out as the most prevalent, each affecting 6.3% of the patients in the study (n = 10). Majority of complications (93.5%) were classified as mild according to Clavien–Dindo classification. For total laryngectomy patients, alcohol consumption, a high ASA classification, and TNM stage IV were identified as significant risk factors for overall complications. In partial laryngectomy patients, low preoperative hemoglobin levels (< 12.5g/L) emerged as an independent risk factor for local complications. For total laryngectomy patients, both a high ASA classification and a BMI exceeding 25kg/m ² were associated with local complications, while low preoperative hemoglobin was a key risk factor for airway complications. No significant risk factors were identified for overall and airway complications in partial laryngectomy patients. Conclusions This study reports a typical incidence and mild severity of early postoperative complications following laryngectomy. Severe complications and mortality rates post-laryngectomy are notably infrequent. The ASA classification and preoperative nutritional status are suggested as potential predictors of early postoperative complications in laryngectomy patients. Trial registration Not applicable