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Pharyngocutaneous fistula complicating laryngectomy: can metronidazole help?
Theodoros Stathas1, Antonios Mallis, Nicholas S Mastronikolis
1ENT Department, University Hospital of Patras, Patras, Greece. ent.upatras@gmail.com
Aim:
To evaluate the use of metronidazole as a prophylactic agent against pharyngocutaneous fistula (PCF) formation.
Patients And Methods:
Seventy patients who underwent total laryngectomy between 2000 and 2008 in our department were divided into two groups. The first group (M+ group) was placed on a 10-day metronidazole regimen (2 days prior to surgery and 7 days following). The second group (M- group) received only regular preoperative chemoprophylaxis.
Results:
In total, 17 (24.3%) incidents of PCF were reported, 3 of which were in the M+ group, with the remainder in the M- group. A statistically significant reduction in the PCF rate was noted in favor of metronidazole in the overall population (p = 0.005), as well as in the patient group that had received radiotherapy prior to surgery (p = 0.03).
Conclusion:
Metronidazole administered for a total of 10 days pre- and postoperatively seems to lower the incidence rate of PCF formation.
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