Back to Search
Start Over
Post-operative pharyngocutaneous fistula after laryngectomy
- Source :
- Auris Nasus Larynx. 35:203-208
- Publication Year :
- 2008
- Publisher :
- Elsevier BV, 2008.
-
Abstract
- 金沢大学附属病院耳鼻咽喉科<br />Objectives: Although organ-preserving radiotherapy or chemoradiotherapy has offered good locoregional control, many patients still experience recurrent disease requiring salvage laryngectomy. The pharyngocutaneous fistula (PCF) is a common and troublesome complication in the early post-operative period after laryngectomy. Here, we evaluated the cause of PCF after laryngectomy, with special emphasis on radiotherapy and/or chemotherapy. Patients and methods: A total of 63 consecutive patients undergoing salvage total laryngectomy for squamous cell carcinoma of the larynx at Kanazawa University Hospital from 1990 to 2005 were reviewed. Forty of the 63 had received primary total laryngectomy (PL). Ten patients underwent radiotherapy alone (SL-RT) and 13 patients underwent concurrent chemoradiotherapy (SL-CRT) followed by salvage laryngectomy. Results: Overall, 17 of the 63 patients (27.0%) developed PCF after laryngectomy. Fisher's exact test showed a significant increase of PCF formation in SL-CRT (7/13, 53.8%) compared with PL (7/40, 17.5%) (p = 0.0252). There were non-significant increases of PCF formation both in SL-CRT (7/13, 53.8%) compared with SL-RT (3/10, 30.0%) (p = 0.4015), and also in SL-RT (3/10, 30.0%) compared with PL (7/40, 17.5%) (p = 0.3969). The Mann-Whitney U-test showed that the duration of PCF was significantly longer for SL-CRT PCF (121.2 ± 95.0 days) compared with those for PL (39.0 ± 55.3 days) (p = 0.0298) or SL-RT (28.0 ± 16.2 days) (p = 0.0325). However, we did not find a significant difference in the duration of PCF with respect to PL (39.0 ± 55.3 days) and SL-RT (28.0 ± 16.2 days) (p = 0.4367). Conclusions: Although radiotherapy or chemotherapy has only a limited impact on PCF formation, concurrent chemoradiotherapy significantly increases PCF formation. The addition of chemotherapy to irradiation delays PCF closure. © 2007 Elsevier Ireland Ltd. All rights reserved.
- Subjects :
- Male
Larynx
medicine.medical_specialty
Cutaneous Fistula
medicine.medical_treatment
Salvage therapy
Salvage laryngectomy
Laryngectomy
Pharyngocutaneous Fistula
Postoperative Complications
medicine
Carcinoma
Chemotherapy
Humans
Laryngeal carcinoma
Laryngeal Neoplasms
Salvage Therapy
Radiotherapy
business.industry
Pharyngeal Diseases
General Medicine
Middle Aged
medicine.disease
Surgery
Radiation therapy
medicine.anatomical_structure
Otorhinolaryngology
Chemotherapy, Adjuvant
Pharyngocutaneous fistulae
Carcinoma, Squamous Cell
Female
Radiotherapy, Adjuvant
Respiratory Tract Fistula
Complication
business
Chemoradiotherapy
Subjects
Details
- ISSN :
- 03858146
- Volume :
- 35
- Database :
- OpenAIRE
- Journal :
- Auris Nasus Larynx
- Accession number :
- edsair.doi.dedup.....cd2154b720d558305c456ad6551835cc
- Full Text :
- https://doi.org/10.1016/j.anl.2007.06.002