Liang, Ji-Wang, Li, Zhen-Dong, Li, Shu-Chun, Fang, Feng-Qin, Zhao, Yue-Jiao, and Li, Yan-Guo
Objective The pharyngocutaneous fistula (PCF) is the troublesome complication after total laryngectomy. Despite a large number of investigations having been performed, there is still controversy about which factors are most significant for PCF. The objective of the present meta-analysis was to analyze the potential risk factors for PCF after total laryngectomy. Data sources Published English-language literature. Review methods PubMed, Ovid, Cochrane, and Web of Science databases were systematically searched using multiple search terms. Twenty-one studies with 3832 patients were identified. The quality of evidence was assessed by The National Institute for Health and Clinical Excellence. Results Sixteen studies involving 2598 patients were included for the meta-analysis. The results showed that, tumor subsite (RR = 0.64, 95% CI 0.47–0.88, P < 0.01), T stage (RR = 0.70, 95% CI 0.51–0.96, P = 0.03), previous radiotherapy (RR = 0.62, 95% CI 0.46–0.84, P < 0.01), postoperative hemoglobin <12.5 g/L (RR = 0.46, 95% CI 0.27–0.76, P < 0.01), and surgical margin (RR = 0.41, 95% CI 0.22–0.74, P < 0.01) were the risk factors associated with the development of PCF. Conclusions From the results of our study, several significant risk factors for PCF are identified. Methodologically high-quality comparative studies are needed for further evaluation. [ABSTRACT FROM AUTHOR]