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- Title
Pharyngocutaneous fistula after total laryngectomy: multivariate analysis of risk factors and a severity-based classification proposal.
- Authors
Casasayas, Maria; Sansa, Aina; García-Lorenzo, Jacinto; López, Montserrat; Orús, César; Peláez, Xavier; Quer, Miquel; León, Xavier
- Abstract
Purpose: The aim of the study is to determine the predisposing factors for pharyngocutaneous fistula (PCF) in patients undergoing total laryngectomy (TL) or extended TL and, secondarily, to propose a new severity-based classification system.Methods: This is a retrospective study of 400 patients who underwent TL or extended TL. Major fistula was defined as a fistula (1) persisting for ≥ 4 weeks, (2) requiring surgical treatment, or (3) associated with perioperative mortality.Results: PCF formation occurred in 93 patients (23.3%) and major fistula in 72 (18.0%). Extended surgery with partial or total pharyngectomy, previous treatment with radiotherapy, and postoperative hemoglobin levels < 99 g/L were associated with a significantly higher risk of developing major fistula.Conclusions: We propose a new PCF classification system according to clinical severity. Predictors of major fistula were the type of surgery, previous radiotherapy, and low (< 99 g/L) postoperative hemoglobin levels. We consider the use of onlay flaps in irradiated patients who require partial pharyngectomy.
- Subjects
FACTOR analysis; RISK assessment; MULTIVARIATE analysis; DISEASE risk factors; FISTULA
- Publication
European Archives of Oto-Rhino-Laryngology, 2019, Vol 276, Issue 1, p143
- ISSN
0937-4477
- Publication type
Article
- DOI
10.1007/s00405-018-5200-4