[Cortisone treatment in prevention of pharyngocutaneous fistula after total laryngectomy].

PURPOSE: To identify a method of prophylaxis in pharyngocutaneous fistula (PCF) after radical surgery for cancer of larynx and pyriform fossa.

MATERIALS AND

METHODS

A prospective longitudinal study on patients who were operated for cancer of larynx and pyriform fossa, in year 2007 in ENT Department of Clinic Emergency County Hospital Cluj-Napoca, with total laryngectomy and partial hypo-pharyngectomy. These patients were distributed in two lots: case (who received postoperative treatment with hemisuccinate of hydrocortisone or dexamethasone) and witness (they didn't received cortisone or other treatment except the standard therapy). We followed the detection of PCF at these 2 lots of patients and the time of resumption for naturally feeding and hospitalization. We performed the bi-variant analysis (Spearman).

RESULTS

23 patient were accomplished the inclusion and exclusion criteria. 4 of those patients developed postoperative pharyngo-cutaneous fistula, only one in the case lot. Statistically, cortisone administrated postoperative brought benefits: PCF was developed in a significant reduced proportion (p=0.02) and the resumption of naturally feeding was made in a significant shorter time (p=0.003) and hospitalization time was significantly reduced (p=0.001).

CONCLUSION

Cortisone administration after total laryngectomy and partial hypo-pharyngectomy seems to be a prophylactic method for pharyngocutaneous fistula.