Pharyngocutaneous fistula following total laryngectomy

Revista Brasileira de Otorrinolaringologia

Aires, Felipe Toyama¹  Castro, Mario Augusto Ferrari de²  Ribeiro, Daniel Araki³  Dedivitis, Rogério Aparecido⁴  Cernea, Claudio Roberto⁵ 

[1] Centro Universitário Lusíada, Santos;Santa Casa da Misericórdia de Santos, Santos;Universidade Federal de São Paulo, Santos;Universidade de São Paulo;Universidade de São Paulo, São Paulo

关键词: carcinoma;    squamous cell;    cutaneous fistula;    laryngeal neoplasms;    laryngectomy;    postoperative complications.;   

DOI  :  10.5935/1808-8694.20120040

学科分类：医学（综合）

来源: Associacao Brasileira de Otorrinolaringologia e Cirurgia Cervicofacial

【 摘 要 】

Pharyngocutaneous fistula (PCF) is the most common complication after total laryngectomy. OBJECTIVES: To establish the incidence of this complication and to analyze the predisposing factors. METHOD: This is a cross-sectional study of a historical cohort including 94 patients who underwent total laryngectomy. The following aspects were correlated to the occurrence of PCF: gender, age, tumor site, TNM staging, type of neck dissection, previous radiation therapy, previous tracheotomy, and use of stapler for pharyngeal closure. The following were considered in PCF cases: the day into postoperative care when the fistula was diagnosed, duration of occurrence, and proposed treatment. RESULTS: Twenty (21.3%) patients had PCF. The incidence of PCF was statistically higher in T4 tumors when compared to T2 and T3 neoplasms (p = 0.03). The other analyzed correlations were not statistically significant. However, 40.9% of the patients submitted to tracheostomy previously had fistulae, against 21.1% of the patients not submitted to this procedure. CONCLUSION: Advanced primary tumor staging is correlated with higher incidences of PCF.

【 授权许可】

CC BY