Abstract
To evaluate the incidence of pharyngocutaneous fistula after total laryngectomy and try to identify its predictors. From May 2005 to April 2010, 93 patients underwent total laryngectomy. We evaluated complications during and after surgery and compared them with the following variables: gender, nutritional status, previous tracheotomy, tumor location, type of surgery, TNM staging, prior treatment with chemotherapy and/or radiotherapy, use of flaps for reconstruction and surgical margin. All patients presented with advanced neoplastic disease according to TNM. 14 (15.1%) patients developed postoperative salivary fistula. The mean time to onset of salivary fistula was 3.5 days, with a standard deviation of 13.7 days. Comparing salivary fistula with TNM variables, type of operation and neck dissection, prior tracheotomy, use of flap, preoperative radio and chemotherapy and surgical margin, there was no statistically significant difference (p> 0,05). The incidence of salivary fistula was 15.1% and no predictive factor for its formation was found.
Highlights
Surgery for head and neck cancer routinely addresses elderly, smoker patients, with vascular diseases, diabetes and other diseases that predispose to various postoperative complications that are directly associated with increased morbidity, hospitalization time and cost of treatment[1,2,3,4,5].Complications may be general or specific
The risk factors identified as predictors of fistula are: malnutrition, compromised surgical margins, radiotherapy, neck dissection, previous tracheotomy, advanced tumor stage and poor surgical technique[1,2,3,4,5,6]
We evaluated the complications during and after surgery and compared with the following variables: gender, nutritional status, previous tracheotomy, tumor location, type of surgery, staging according to the TNM7, prior chemotherapy and / or radiation therapy, use of flaps for reconstruction and surgical margin
Summary
Surgery for head and neck cancer routinely addresses elderly, smoker patients, with vascular diseases, diabetes and other diseases that predispose to various postoperative complications that are directly associated with increased morbidity, hospitalization time and cost of treatment[1,2,3,4,5]. As for the specific complications, they are related to the surgical procedure performed. Amongst the complications related to laryngectomy, pharyngocutaneous fistula is most common after total laryngectomy, with an incidence of 3% to 65%. The risk factors identified as predictors of fistula are: malnutrition, compromised surgical margins, radiotherapy, neck dissection, previous tracheotomy, advanced tumor stage and poor surgical technique[1,2,3,4,5,6]
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