Pharyngocutaneous Fistula Following Primary and Salvage Laryngectomy: Aetiology and Predictive Factors

Michael, Rajiv C; Das, Sukamal; Mani, Suresh; Arunagiri, Sabarinath; Thomas, Regi; Sundaresan, Rajan; Philip, Dona Maria

doi:10.1007/s12070-020-02046-x

Cited by 4 publications

(5 citation statements)

References 30 publications

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“…The second independent risk factor for PCF identified in our study was an invasion of the piriform sinus ( p < 0.001). Similar results were reported by Michael et al [ 31 ] and Mendelsohn et al [ 32 ]. However, in recent meta-analyses, a piriform sinus invasion was recognized as a significant risk factor only by Dedivitis et al, increasing the risk of PCF by 9% [ 4 ].…”

Section: Discussionsupporting

confidence: 92%

“…When parts of oropharyngeal and/or hypopharyngeal mucosa are included in a surgical resection, less tissue remains available for the primary closure of the neopharynx. If it is performed under tension or even without the appropriate inversion of the mucosa into the lumen of the neopharyngeal canal, the wound is more prone to break down and dehiscence which both raise the risk for PCF [ 18 , 31 ].…”

Section: Discussionmentioning

confidence: 99%

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The Incidence and the Risk Factors for Pharyngocutaneous Fistula following Primary and Salvage Total Laryngectomy

Šifrer

Strojan

Tancer

et al. 2023

Cancers

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The pharyngocutaneous fistula (PCF) is the most common complication following a total laryngectomy (TL) with a wide range of incidence and various potential risk factors. The aim was to analyse the incidence and potential risk factors for PCF formation in a large study set collected over a longer period of time. In the retrospective study at the Department of Otorhinolaryngology and Cervicofacial Surgery of Ljubljana, 422 patients who were treated for head and neck cancer by TL between 2007 and 2020 were included. The comprehensive clinicopathologic data were collected including potential risk factors related to the patient, disease, surgical treatment and post-operative period for the development of fistulae. The patients were categorized into a group with the fistula (a study group) and one without it (a control group). The PCF then developed in 23.9% of patients. The incidence following a primary TL was 20.8% and 32.7% following salvage TL (p = 0.012). The results demonstrated that surgical wound infection, piriform sinus invasion, salvage TL, and total radiation dose were determined as independent risk factors for PCF formation. A diminishing surgical wound infection rate would contribute to a further reduction of the PCF rate.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

The Incidence and the Risk Factors for Pharyngocutaneous Fistula following Primary and Salvage Total Laryngectomy

Šifrer

Strojan

Tancer

et al. 2023

Cancers

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show abstract

“…Among them, The most accurate predictor of pharyngocutaneous fistula (PCF) occurrence is postoperative hypoalbuminaemia. Michael et al 9 analysed patients with primary and salvage laryngectomy for the treatment of laryngeal squamous cell carcinoma and hypopharyngeal squamous cell carcinoma, summarized the relevant factors for the formation of PCF, and conducted a retrospective analysis of 127 total laryngectomy patients. The data of 127 patients with total laryngectomy were retrospectively analysed.…”

Section: Introductionmentioning

confidence: 99%

Risk factors and healing factors for pharyngocutaneous fistula after total laryngectomy for laryngeal cancer: An epidemiological study

Tai,

Liu,

Liu

et al. 2024

International Wound Journal

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To analyse the risk factors and healing factors of pharyngocutaneous fistula (PCF) in patients with laryngeal cancer after total laryngectomy, and to explore the relevant epidemiology. A retrospective analysis was conducted on laryngeal cancer patients who underwent total laryngectomy in our hospital from January 2010 to December 2022. The 349 patients included in the study were divided into a PCF group of 79 and a non‐PCF group of 270. Perform one‐way analysis of variance and multivariate logistic analysis on various data of patients included in the statistics, and analyse the risk factors and healing factors of PCF. Smoking, history of radiation therapy for laryngeal cancer, history of chemotherapy for laryngeal cancer, tumour location (larynx, pharynx, oesophagus), preoperative albumin, postoperative proteinaemia, <99 haemoglobin, postoperative haemoglobin, postoperative C‐reactive protein (CRP) level are the risk factors for PCF. Also, radiation therapy and postoperative proteinaemia were the main reasons for preventing PCF healing. Smoking history, laryngeal cancer, radiation therapy, albumin, haemoglobin and CRP are risk factors for postoperative PCF after total laryngectomy, while radiation therapy and postoperative hypoalbuminaemia are key factors affecting PCF healing.

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“…Complications following treatment are frequent [ 2 ]. Surgery is the mainstay for advanced laryngeal cancer, particularly those causing laryngeal dysfunction or involving large tumors [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Management of pharyngocutaneous fistula following laryngectomy with autologous fat graft: A case report and literature review

Alabdullah,

Shaker,

Alomar

et al. 2024

International Journal of Surgery Case Reports

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Pharyngocutaneous Fistula Following Primary and Salvage Laryngectomy: Aetiology and Predictive Factors

Cited by 4 publications

References 30 publications

The Incidence and the Risk Factors for Pharyngocutaneous Fistula following Primary and Salvage Total Laryngectomy

The Incidence and the Risk Factors for Pharyngocutaneous Fistula following Primary and Salvage Total Laryngectomy

Risk factors and healing factors for pharyngocutaneous fistula after total laryngectomy for laryngeal cancer: An epidemiological study

Management of pharyngocutaneous fistula following laryngectomy with autologous fat graft: A case report and literature review

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