Pharyngocutaneous fistula after total laryngectomy: multivariate analysis of risk factors and a severity-based classification proposal

Maria Casasayas, Aina Sansa, Jacinto García-Lorenzo, Montserrat López, César Orús, Xavier Peláez, Miquel Quer, Xavier León

Research output: Contribution to journalArticleResearch

6 Citations (Scopus)

Abstract

© 2018, Springer-Verlag GmbH Germany, part of Springer Nature. 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.
Original languageEnglish
Pages (from-to)143-151
JournalEuropean Archives of Oto-Rhino-Laryngology
Volume276
DOIs
Publication statusPublished - 24 Jan 2019

Keywords

  • Cancer larynx
  • Pharyngectomy
  • Pharyngocutaneous fistula
  • Postoperative complications
  • Total laryngectomy

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