Pharyngocutaneous fistula following total laryngectomy

Pharyngocutaneous fistula (PCF) is the most common complication after total laryngectomy. To establish the incidence of this complication and to analyze the predisposing factors. This is a cross-sectional study of a historical cohort including 94 patients who underwent total laryngectomy. The follow...

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Bibliographic Details
Published in:Brazilian journal of otorhinolaryngology 2012-11, Vol.78 (6), p.94-98
Main Authors: Aires, Felipe Toyama, Dedivitis, Rogério Aparecido, de Castro, Mario Augusto Ferrari, Ribeiro, Daniel Araki, Cernea, Claudio Roberto, Brandão, Lenine Garcia
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
carcinoma
Carcinoma, Squamous Cell - surgery
Cross-Sectional Studies
cutaneous fistula
Cutaneous Fistula - etiology
Female
Fistula - etiology
Humans
laryngeal neoplasms
Laryngeal Neoplasms - surgery
laryngectomy
Laryngectomy - adverse effects
Male
Middle Aged
Original
Pharyngeal Diseases - etiology
postoperative complications
Risk Factors
squamous cell
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Summary:Pharyngocutaneous fistula (PCF) is the most common complication after total laryngectomy. To establish the incidence of this complication and to analyze the predisposing factors. 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. 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. Advanced primary tumor staging is correlated with higher incidences of PCF.
ISSN:1808-8694
1808-8686
DOI:10.5935/1808-8694.20120040