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Desk work earlier, manual work later; depends on adjuvant radiotherapy, voice rehabilitation and health."},"complication_rate_pct":{"min":20,"max":40,"unit":"percent","qualifier":"Early complications, mainly pharyngocutaneous fistula, wound infection or breakdown; higher after prior radiation or chemoradiotherapy. Varies by series."},"contraindications":["Unresectable disease, e.g., prevertebral fascia invasion or carotid artery encasement","Distant metastases where curative surgery is inappropriate (palliative only selectively)","Unfit for general anesthesia and major surgery","Refusal of permanent voice loss and neck stoma","Active infection or severe malnutrition (relative; optimize first)","Tumor extent preventing functional or reconstructive closure"],"days_in_clinic":{"min":7,"max":14,"unit":"nights","qualifier":"Uncomplicated total laryngectomy with primary closure, no free flap, counted from surgery; longer with fistula, flap or complications."},"diagnostic_duration_minutes":null,"diagnostic_preparation":null,"diagnostic_referral_needed":null,"diagnostic_result_time_hours":null,"exercise_resume_weeks":{"min":6,"max":12,"unit":"weeks","qualifier":"From surgery, for strenuous exercise and heavy lifting after surgeon clearance. Walking starts within days; swimming needs stoma protection."},"final_result_months":{"min":6,"max":12,"unit":"months","qualifier":"From surgery, to stable swallowing, stoma care and speech; longer if adjuvant radiotherapy is needed."},"fly_home_after_days":{"min":14,"max":28,"unit":"days","qualifier":"From surgery, once discharged with no fistula, stable stoma, oral intake and surgeon clearance; later with complications."},"follow_up_visits":[{"purpose":"wound_check","requirement":"routine","after":{"min":7,"max":21,"unit":"days","qualifier":"After surgery; wound, stoma, swallowing and nutrition review, with drain and suture removal as needed, usually soon after discharge."}},{"purpose":"result_review","requirement":"routine","after":{"min":14,"max":28,"unit":"days","qualifier":"After surgery; pathology review and adjuvant therapy planning with the tumor board."}},{"purpose":"rehabilitation","requirement":"routine","after":{"min":28,"max":60,"unit":"days","qualifier":"After surgery; speech-language pathology review, voice rehabilitation planning and prosthesis fitting or evaluation where relevant."}},{"purpose":"assessment","requirement":"routine","after":{"min":90,"max":120,"unit":"days","qualifier":"After surgery; start of regular cancer surveillance, which continues for years at intervals set by the oncology team."}}],"indications":["Advanced T3-T4 laryngeal or hypopharyngeal cancer unsuitable for organ preservation","Nonfunctional larynx in selected T3 cancer","Recurrent laryngeal cancer after radiotherapy (salvage surgery)","Radioresistant or non-conservative tumors, e.g., chondrosarcoma, sarcomas","Severe laryngeal trauma precluding functional reconstruction","Nonfunctional larynx with life-threatening chronic aspiration","Severe radionecrosis or chondronecrosis of the larynx"],"main_risks":["Pharyngocutaneous fistula, more likely after prior radiation or neck dissection","Wound infection, hematoma or wound breakdown","Pharyngeal stricture and swallowing difficulty","Stomal stenosis","Permanent loss of natural voice","Hypothyroidism","Chyle leak, mainly with neck dissection","Cancer recurrence","Anesthetic, cardiopulmonary and thromboembolic complications","Depression and psychosocial impact","Shoulder dysfunction or neck numbness after neck dissection"],"pain":"Moderate postoperative pain in the first days to weeks, controlled with multimodal analgesia. Neck tightness and numbness may persist, and swallowing discomfort is common early.","preparation":["Staging: endoscopy, biopsy, neck and chest imaging, PET/CT if advanced","Multidisciplinary tumor board review","Anesthesia and medical assessment, including cardiopulmonary and nutritional status","Blood tests: count, kidney, liver, albumin, thyroid, blood type","Optimization of anemia and comorbidities such as COPD and diabetes","Smoking and alcohol cessation, with withdrawal monitoring","Speech therapist counseling on voice loss, stoma care, communication","Dental assessment if radiotherapy is planned","Medication review, including anticoagulants; fasting as instructed"],"recovery_timeline":[{"phase":"Hospital stay (about 7-14 nights)","description":"Uncomplicated primary protocol with stoma suctioning, humidification, drains, tube feeding and stoma-care teaching. Walking starts within 1-2 days; oral feeding often around days 7-10.","restrictions":["No oral intake initially; tube feeding","Obligate neck breather: cannot be intubated orally or nasally","Nonverbal communication until rehabilitation starts","Light walking only; no lifting"]},{"phase":"Early recovery (about weeks 2-6)","description":"Wound healing, return to oral diet, stoma care and speech rehabilitation start. Adjuvant radiotherapy or chemoradiotherapy may follow if pathology shows high-risk features.","restrictions":["Avoid heavy lifting and strenuous exercise","Protect stoma from water, dust and cold air; use humidification","No swimming or immersion"]},{"phase":"Rehabilitation (about weeks 6-12 and beyond)","description":"Voice rehabilitation with tracheoesophageal prosthesis, electrolarynx or esophageal speech; work and exercise resume after surgeon clearance. Full adaptation may take 6-12 months.","restrictions":["Permanent stoma precautions, including avoiding open water and immersion","Water sports only with surgeon advice and special equipment"]},{"phase":"At any time","description":"Seek urgent care for breathing difficulty, stoma blockage, bleeding, fever, neck swelling, wound leakage, chest pain or leg swelling. Prosthesis leakage with coughing needs review.","restrictions":["Do not delay urgent assessment until a scheduled visit"]}],"rehabilitation_days":{"min":30,"max":90,"unit":"days","qualifier":"From surgery, for functional recovery of swallowing, stoma care and basic communication; full voice rehabilitation takes longer."},"result_longevity":"Larynx removal and airway separation are permanent. Cancer control depends on stage, margins and adjuvant therapy, with long-term surveillance. Voice prostheses need replacement, often every few months.","revision_rate_pct":{"min":5,"max":15,"unit":"percent","qualifier":"Unplanned reoperation within about 90 days of primary total laryngectomy (fistula, hematoma, wound or stoma issues); higher after salvage."},"scars":"Neck incision scar and a permanent end tracheostoma at the base of the neck; the scar is larger with neck dissection or flap reconstruction.","sessions_or_stages":{"sessions":{"min":1,"max":1,"unit":"visits","qualifier":"Single operation; voice prosthesis puncture may be done at the same time or later."},"stages":[{"code":"total_laryngectomy","label":"Total laryngectomy with permanent tracheostoma, with or without neck dissection","after":{"min":0,"max":0,"unit":"days","qualifier":"Performed on the day of surgery."}}],"qualifier":"Adult primary total laryngectomy under general anesthesia, inpatient, single operation."},"success":{"metric":"Technical completion of total laryngectomy with a healed pharyngeal closure and stable permanent tracheostoma, without major reoperation","value":70,"unit":"percent","horizon":"Within about 3 months after surgery","population":"Adults undergoing primary total laryngectomy with primary closure for advanced laryngeal cancer; lower after salvage surgery","evidence_status":"limited"},"techniques":[{"name":"Total laryngectomy with primary pharyngeal closure (primary protocol)","suits_whom":"Adults with advanced laryngeal cancer whose remaining pharyngeal mucosa can be closed without tension","recovery":"Inpatient recovery; oral feeding usually starts after healing is confirmed, with tube feeding in the meantime."},{"name":"Total laryngectomy with regional or free flap reconstruction (outside the primary numerical profile)","suits_whom":"Patients with insufficient pharyngeal mucosa, prior radiation, extralaryngeal extension or extended resection","recovery":"Longer operation and hospital course than the primary protocol; a vascularized flap may lower fistula risk in high-risk patients."},{"name":"Total laryngectomy with concurrent neck dissection (included in the primary profile when needed)","suits_whom":"Patients with nodal disease or high risk of nodal metastasis","recovery":"Longer operation and larger wound; neck dissection is a fistula risk factor and may cause shoulder symptoms."},{"name":"Primary or secondary tracheoesophageal puncture with voice prosthesis (outside the primary numerical profile)","suits_whom":"Selected patients wanting tracheoesophageal speech","recovery":"Done at laryngectomy or later; speech training follows."}],"treatment_conditions":["inpatient"],"treatment_duration_hours":{"min":4,"max":8,"unit":"hours","qualifier":"Skin to skin, with primary closure, with or without neck dissection; longer with free-flap reconstruction."},"initial_assessment_documents":["Laryngoscopy or endoscopy report","Biopsy and histopathology report","Neck and chest CT or MRI","PET-CT report (if available)","Previous radiotherapy or chemotherapy records (if available)","Recent blood tests and anesthesia fitness report"],"travel_trips":{"min":1,"max":1,"one_trip_possible":true,"qualifier":"Single operation; stay about 2-4 weeks until discharge and surgeon clearance. Adjuvant therapy and surveillance usually continue at home."}}},"hrefLanguages":[{"rel":"alternate","hreflang":"ru","language":"ru","href":"https://ru.bookimed.com/clinics/country=brazil/city=brazilia/procedure=laringektomiya/"}],"offerFilters":{"offer_count":0,"price_filter":{"from":0,"to":0,"avg":0}},"illnessesByOperation":[{"id":2,"alias":"larynx-cancer","name":"سرطان الحنجرة"}],"rendersOffersList":false}