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Erschienen in: European Archives of Oto-Rhino-Laryngology 1/2019

13.11.2018 | Laryngology

Pharyngocutaneous fistula after total laryngectomy: multivariate analysis of risk factors and a severity-based classification proposal

verfasst von: Maria Casasayas, Aina Sansa, Jacinto García-Lorenzo, Montserrat López, César Orús, Xavier Peláez, Miquel Quer, Xavier León

Erschienen in: European Archives of Oto-Rhino-Laryngology | Ausgabe 1/2019

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Abstract

Purpose

The aim of the study is to determine the predisposing factors for pharyngocutaneous fistula (PCF) in patients undergoing total laryngectomy (TL) or extended TL and, secondarily, to propose a new severity-based classification system.

Methods

This is a retrospective study of 400 patients who underwent TL or extended TL. Major fistula was defined as a fistula (1) persisting for ≥ 4 weeks, (2) requiring surgical treatment, or (3) associated with perioperative mortality.

Results

PCF formation occurred in 93 patients (23.3%) and major fistula in 72 (18.0%). Extended surgery with partial or total pharyngectomy, previous treatment with radiotherapy, and postoperative hemoglobin levels < 99 g/L were associated with a significantly higher risk of developing major fistula.

Conclusions

We propose a new PCF classification system according to clinical severity. Predictors of major fistula were the type of surgery, previous radiotherapy, and low (< 99 g/L) postoperative hemoglobin levels. We consider the use of onlay flaps in irradiated patients who require partial pharyngectomy.
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Metadaten
Titel
Pharyngocutaneous fistula after total laryngectomy: multivariate analysis of risk factors and a severity-based classification proposal
verfasst von
Maria Casasayas
Aina Sansa
Jacinto García-Lorenzo
Montserrat López
César Orús
Xavier Peláez
Miquel Quer
Xavier León
Publikationsdatum
13.11.2018
Verlag
Springer Berlin Heidelberg
Erschienen in
European Archives of Oto-Rhino-Laryngology / Ausgabe 1/2019
Print ISSN: 0937-4477
Elektronische ISSN: 1434-4726
DOI
https://doi.org/10.1007/s00405-018-5200-4

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