Qureshi S S, Chaturvedi P, Pai P S, Chaukar D A, Deshpande M S, Pathak K A, D'cruz A K
Department of Surgery, Head and Neck Surgical Service, Tata Memorial Hospital, Mumbai, India.
J Cancer Res Ther. 2005 Jan-Mar;1(1):51-6. doi: 10.4103/0973-1482.16092.
Pharyngocutaneous (PC) fistula is a common complication following laryngectomy. It leads to increased morbidity, delay in adjuvant treatment, prolonged hospitalization and an increase in treatment costs. Although a number of factors that result in PC fistula have been described, there is still no agreement on the most significant factors. We undertook a prospective study to critically analyze PC fistula and its association with various tumors, patient and treatment related factors. This was a prospective study that included 143 patients who underwent laryngeal surgery for squamous cell carcinoma of the larynx and pyriform sinus. Use of pectoralis major myocutaneous flap to reconstruct the neopharynx, primary disease in pyriform and extensive soft tissue infiltration were significantly associated with PC fistula. Prior treatment (radiotherapy and chemotherapy), type of closure (T closure, Y closure and vertical closure), Layers of closure (full thickness interrupted, submucosal interrupted, submucosal continuous) type of suture material (silk, vicryl ), age, sex, stage, preoperative tracheostomy, cut margin status, pre/postoperative hemoglobin and experience of surgeons did not relate significantly.
咽皮肤瘘是喉切除术后常见的并发症。它会导致发病率增加、辅助治疗延迟、住院时间延长以及治疗费用增加。尽管已经描述了许多导致咽皮肤瘘的因素，但对于最重要的因素仍未达成共识。我们进行了一项前瞻性研究，以严格分析咽皮肤瘘及其与各种肿瘤、患者和治疗相关因素的关联。这是一项前瞻性研究，纳入了143例行喉鳞状细胞癌和梨状窝手术的患者。使用胸大肌肌皮瓣重建下咽、梨状窝原发性疾病和广泛的软组织浸润与咽皮肤瘘显著相关。既往治疗（放疗和化疗）、缝合方式（T形缝合、Y形缝合和垂直缝合）、缝合层数（全层间断、黏膜下间断、黏膜下连续）、缝合材料类型（丝线、薇乔）、年龄、性别、分期、术前气管切开、切缘状态、术前/术后血红蛋白以及外科医生的经验均无显著相关性。
