Abstract |
Pharyngo- cutaneous fistula is a serious complication of laryngectomy, with a significant associated morbidity and mortality. The oncologic success of organ-preservation protocols with radiotherapy or chemo- radiotherapy for laryngeal carcinoma means laryngectomy is increasingly reserved for surgical salvage in the event of persistent or recurrent disease. A retrospective review of fistula incidence after laryngectomy in 171 patients in a UK tertiary referral centre over the last decade was conducted to identify trends in this complication in the epoch of non-surgical organ preservation. The overall fistula incidence following laryngectomy is 29.2% (50/171). Fistula incidence following salvage total laryngectomy is significantly higher than after primary total laryngectomy [19/51 (37.3%) vs. 8/47 (17.0%), χ2 = 5.02, p = 0.03]. There is no significant effect of prior treatment on fistula incidence following laryngo- pharyngectomy or pharyngo-laryngo-oesophagectomy [14/39 (35.9%) vs. 9/27 (33.3%), χ2 = 0.05, p = 0.83]. Prophylactic vascularised tissue flaps to reinforce the pharyngeal suture line may reduce fistula incidence and fistula severity in salvage total laryngectomy.
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Authors | Mark Sayles, Stephanie L Koonce, Laura Harrison, Nigel Beasley, Andrew R McRae, David G Grant |
Journal | European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery
(Eur Arch Otorhinolaryngol)
Vol. 271
Issue 6
Pg. 1765-9
(Jun 2014)
ISSN: 1434-4726 [Electronic] Germany |
PMID | 24077872
(Publication Type: Journal Article)
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Topics |
- Adult
- Aged
- Aged, 80 and over
- Carcinoma
(surgery, therapy)
- Chemoradiotherapy
- Cohort Studies
- Cutaneous Fistula
(epidemiology, prevention & control)
- Female
- Humans
- Laryngeal Neoplasms
(surgery, therapy)
- Laryngectomy
- Male
- Middle Aged
- Organ Sparing Treatments
- Pharyngeal Diseases
(epidemiology, prevention & control)
- Postoperative Complications
(epidemiology, prevention & control)
- Retrospective Studies
- Risk Factors
- Salvage Therapy
- Surgical Flaps
- Treatment Failure
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