Pharyngocutaneous fistula following total laryngectomy |
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| Authors: | Felipe Toyama Aires Rogério Aparecido Dedivitis Mario Augusto Ferrari de Castro Daniel Araki Ribeiro Claudio Roberto Cernea Lenine Garcia Brandão |
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| Institution: | 1. Medical Student at the Lusíada University Center in Santos - SP (Medical Student at the Lusíada University Center in Santos - SP);2. Senior Associate Professor, Supervisor of the Larynx Group in the Department of Head and Neck Surgery in the Hospital of the Medical School of the University of São Paulo (MD);3. MSc in General Practice by the Lusíada University Center UNILUS (Assisting Physician in the HNS services of the Ana Costa Hospital and the Santa Casa da Misericórdia de Santos, Santos - SP);4. Adjunct Professor and Senior Associate Professor in the Department of Biosciences of the Federal University of São Paulo - UNIFESP - Baixada Santista Campus, Santos;5. Associate Professor in the Department of Head and Neck Surgery of the Medical School of the University of São Paulo, São Paulo (Associate Professor in the Department of Head and Neck Surgery of the Medical School of the University of São Paulo, São Paulo);6. Professor in the Department of Head and Neck Surgery of the Medical School of the University of São Paulo, São Paulo (Professor in the Department of Head and Neck Surgery of the Medical School of the University of São Paulo, São Paulo). Head and Neck Departments - Ana costa and Irmandade da Santa Casa de Misericórdia de Santos - Hospitals. Brazil |
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| Abstract: | Pharyngocutaneous fistula (PCF) is the most common complication after total laryngectomy.ObjectivesTo establish the incidence of this complication and to analyze the predisposing factors.MethodThis 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.ResultsTwenty (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.ConclusionAdvanced primary tumor staging is correlated with higher incidences of PCF. |
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| Keywords: | carcinoma squamous cell cutaneous fistula laryngeal neoplasms laryngectomy postoperative complications |
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