Efficacy of pectoralis major muscle flap for pharyngocutaneous fistula prevention in salvage total laryngectomy: A systematic review

Background The role of pectoralis major muscle flap (PMMF) in reducing the rate of pharyngocutaneous fistula after salvage total laryngectomy has not been clearly established. The purpose of this study was to evaluate the impact of PMMF in reducing pharyngocutaneous fistula rates after total larynge...

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Bibliographic Details
Published in:Head & neck 2016-04, Vol.38 (S1), p.E2317-E2321
Main Authors: Guimarães, André Vicente, Aires, Felipe Toyama, Dedivitis, Rogério Aparecido, Kulcsar, Marco Aurélio Vamondes, Ramos, Daniel Marin, Cernea, Claudio Roberto, Brandão, Lenine Garcia
Format: Article
Language:English
Subjects:
carcinoma
cutaneous fistula
Cutaneous Fistula - prevention & control
Humans
laryngeal neoplasms
Laryngeal Neoplasms - surgery
Laryngectomy
meta-analysis
pectoralis major flap
Pectoralis Muscles - transplantation
Pharyngeal Diseases - prevention & control
postoperative complications
Retrospective Studies
Salvage Therapy
squamous cell
Surgical Flaps - transplantation
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Summary:Background The role of pectoralis major muscle flap (PMMF) in reducing the rate of pharyngocutaneous fistula after salvage total laryngectomy has not been clearly established. The purpose of this study was to evaluate the impact of PMMF in reducing pharyngocutaneous fistula rates after total laryngectomy. Methods The analyzed intervention was the use of a PMMF after total laryngectomy. Results Pharyngocutaneous fistula occurred in 230 cases (global incidence, 30.9%). In the group of patients who underwent PMMFs, there were 49 cases of pharyngocutaneous fistula, compared with 181 cases in the control group. There was a 22% decreased risk of pharyngocutaneous fistula incidence in the PMMF group (p < .001). Patients who underwent a PMMF had lower risk of pharyngocutaneous fistula compared with the control group (p = .008). There were no changes when only patients who underwent total laryngectomy (p < .001) and those who underwent total pharyngolaryngectomy (p = .007) were separately assessed. Conclusion Prophylactic use of PMMF decreases the incidence of pharyngocutaneous fistula after salvage total laryngectomy. © 2015 Wiley Periodicals, Inc. Head Neck 38: E2317–E2321, 2016
ISSN:1043-3074
1097-0347
DOI:10.1002/hed.24248