Brazilian journal of otorhinolaryngology · 2012
[Pharyngocutaneous fistula following total laryngectomy].
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Aires Felipe Toyama, Dedivitis Rogério Aparecido, Castro Mario Augusto Ferrari de, Ribeiro Daniel Araki, Cernea Claudio Roberto, Brandão Lenine Garcia
Аннотация
UNLABELLED: 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.
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.