A) Gastric surgery as a long-term risk factor for malignant lesions of the larynx.

BACKGROUND: Duodenogastroesophageal reflux is common after total or partial gastrectomy. No data are available on the effect of duodenal reflux on the larynx.\r\n\r\nHYPOTHESIS: Premalignant or malignant changes occur more frequently among subjects with gastric surgery.\r\n\r\nDESIGN: Historical cohort study.\r\n\r\nSETTING: Outpatient setting for upper endoscopy.\r\n\r\nPATIENTS: Ninety-three subjects who had undergone gastric resection at least 5 years previously, and 93 matched dyspeptic individuals who did not undergo gastric surgery.\r\n\r\nINTERVENTION: Clinical histories of all patients were obtained and recorded. All subjects underwent an otolaryngologic evaluation.\r\n\r\nRESULTS: Of 93 patients with gastric resection, 7 patients had current or previous laryngeal malignancies or current precancerous mucosal changes. In the control group, 1 subject had a leukoplakia on the vocal cord. The adjusted odds ratio (having included sex, age, and alcohol [yes or no] and smoking [yes or no] history in the regression model) was 9.88 (95% confidence interval, 1.01-97.31; likelihood ratio chi2 = 28.77; P<.001). Furthermore, there was a significant increased prevalence of benign laryngeal lesions in patients with gastric resection vs the control group.\r\n\r\nCONCLUSIONS: The risk of developing laryngeal malignancies is higher for patients with gastric resection. A periodic otolaryngologic evaluation in subjects with gastric surgery may contribute to early diagnosis of laryngeal disorders.