Kasapoğlu Fikret, Erişen Levent, Coşkun Hakan, Basut Oğuz, Tezel Ilker, Hizalan Ibrahim, Onart Selçuk
Department of Otolaryngology, Medicine Faculty of Uludağ University, Bursa, Turkey.
Kulak Burun Bogaz Ihtis Derg. 2003 Jul;11(1):5-10.
This study sought to determine the incidence and etiologic factors of pharyngocutaneous fistulas occurring after total laryngectomy.
A total of 138 patients (136 males, 2 females; mean age 59.5 years; range 36 to 83 years) underwent total laryngectomy for squamous cell carcinoma. Risk factors and the management of pharyngocutaneous fistulas were assessed together with durations in relation to fistula occurrence, oral feeding, hospitalization, and healing.
Pharyngocutaneous fistulas were seen in 37 patients (26.8%). Significantly high rates of fistula occurrence were detected in patients with alcohol consumption (p=0.032), and in those who underwent partial pharyngectomy (p=0.058) or bilateral neck dissection (p=0.049) along with total laryngectomy. The occurrence of fistulas was significantly associated with prolonged lengths of time for oral feeding and hospital stay (p<0.001). Fistulas were repaired surgically in 24.3% of patients, in whom the time to oral feeding was significantly shorter than that of patients who received local wound care (p=0.03).
Our data show that early surgical intervention is more beneficial in preventing further morbidity associated with pharyngocutaneous fistulas.
本研究旨在确定全喉切除术后咽皮肤瘘的发生率及病因。
共有138例患者（男136例，女2例；平均年龄59.5岁；年龄范围36至83岁）因鳞状细胞癌接受全喉切除术。评估咽皮肤瘘的危险因素、处理方法以及与瘘发生、经口进食、住院时间和愈合相关的持续时间。
37例患者（26.8%）出现咽皮肤瘘。在饮酒患者（p = 0.032）、接受部分咽切除术（p = 0.058）或双侧颈清扫术（p = 0.049）联合全喉切除术的患者中，瘘的发生率显著较高。瘘的发生与经口进食时间延长和住院时间显著相关（p < 0.001）。24.3%的患者接受了手术修复，这些患者经口进食的时间明显短于接受局部伤口护理的患者（p = 0.03）。
我们的数据表明，早期手术干预在预防与咽皮肤瘘相关的进一步发病方面更有益。
