Cavalot A L, Gervasio C F, Nazionale G, Albera R, Bussi M, Staffieri A, Ferrero V, Cortesina G
Second ENT Clinic, University of Turin, Italy.
Otolaryngol Head Neck Surg. 2000 Nov;123(5):587-92. doi: 10.1067/mhn.2000.110617.
Pharyngocutaneous fistula is the most common complication of total laryngectomy. The management of this problem increases hospitalization time and delays initiation of postoperative radiotherapy, where indicated. To identify factors predisposing to the development of pharyngocutaneous fistula, we reviewed the postoperative courses of 293 patients who underwent total laryngectomy at our clinic. General factors taken into account were concurrent diseases such as diabetes, liver diseases, or chronic anemia; local factors included radiotherapy before and after surgery, preoperative tracheostomy, type of cervical lymph node removal, and method of pharyngeal closure. We then compared our data with those reported in the literature by other authors. Last, we applied the Fisher exact test to a correlation we found between the higher incidence of fistula in patients with diabetes, liver diseases, or anemia. The local factor that turned out to be statistically most significant for the development of fistula was preoperative radiotherapy.
咽皮肤瘘是全喉切除术最常见的并发症。该问题的处理会延长住院时间，并在有指征时延迟术后放疗的开始。为了确定易发生咽皮肤瘘的因素，我们回顾了在我们诊所接受全喉切除术的293例患者的术后病程。考虑的一般因素包括并发疾病，如糖尿病、肝脏疾病或慢性贫血；局部因素包括手术前后的放疗、术前气管切开术、颈部淋巴结清扫类型以及咽闭合方法。然后我们将我们的数据与其他作者在文献中报道的数据进行了比较。最后，我们对糖尿病、肝脏疾病或贫血患者中瘘发生率较高之间的相关性应用了Fisher精确检验。结果发现，对瘘的发生在统计学上最显著的局部因素是术前放疗。
