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Pharyngocutaneous fistulae in laryngectomy patients: the Toronto Hospital experience
S R Parikh1, J C Irish, A J Curran
1University of Toronto, Department of Otolaryngology/Head and Neck Program, The Toronto Hospital, Ontario.
Objective:
The purpose of this study was to determine the rate of post-laryngectomy pharyngocutaneous fistulae and its association with age, gender, preoperative radiation, TNM staging, patients comorbidity factors, choice of ablation, choice of reconstruction, modality of postoperative feeding, and whether or not a primary tracheoesophageal puncture was performed.
Design:
Retrospective clinical study.
Setting:
The Toronto Hospital/Princess Margaret Hospital, University of Toronto, Toronto, Ontario.
Method:
One hundred and twenty-five consecutive laryngectomy procedures performed between July 1, 1992, and October 1, 1996, were reviewed.
Results:
There was an overall fistula rate of 22%. No association found was between fistula rates and age, gender, patient comorbidity factors, TNM stage, choice of ablation, choice of reconstruction, modality of postoperative feeding, or whether a primary tracheoesophageal puncture was performed or not.
Conclusions:
At this tertiary care head and neck oncology centre, pharyngocutaneous fistulae remain an unpredictable and serious complication with an estimated economic cost of Cdn $400,000 per year.