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[Study of pharyngo-cutaneous fistula after total laryngectomy]
1Department of Otolaryngology, Peking Union Hospital, Chinese Acadamy of Medical Sciences, Peking Union Medical College, Beijing 100730.
Objective:
To explore the factors which lead to pharyngo-cutaneous fistula after total laryngectomy.
Method:
A retrospective study of 125 patients who underwent total laryngectomy during a 16-year period was carried out.
Result:
The rate of post-laryngectomy pharyngo-cutaneous fistula is 16.0% (20/125), it appears reduced tendency. With single-factor analysis, the factors effect on the rate of post-laryngectomy pharyngo-cutaneous fistula include clinical tumor stage, tumor types, pre-operative radiotherapy dose, intraoperative blood transfusion, operative duration. With all variable logistic model analysis, the factors effect on the rate of pharyngo-cutaneous fistula are clinical tumor stage and pre-operative radiotherapy dose, but pre-operative radiotherapy is very possible to be a risk factor (P = 0.0566). With logistic model stepwise regression analysis, the factors effect on the rate of pharyngo-cutaneous fistula are clinical tumor stage and operative duration.
Conclusion:
Pharyngo-cutaneous fistula appears easily in patients with T3, T4 tumor, and have pre-operative radiotherapy, especially have large dose preradiotherapy. For these high risk patients, the duration of operation should be as short as possible to reduce the rate of post-laryngectomy pharyngo-cutaneous fistula.