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135例(咽)喉切除术后的瘘管与狭窄

Fistula and stenosis after 135 (pharyngo)laryngectomies.

作者信息

Dequanter D, Lothaire Ph, Philippart P, De Wan J, Comblain M, Deraemaecker R, Andry G

机构信息

Department of Surgery, Institut Jules Bordet, Centre des Tumeurs de l'Université Libre de Bruxelles, Bruxelles, Belgium.

出版信息

Acta Chir Belg. 2008 Jan-Feb;108(1):98-101.

Abstract

BACKGROUND

Despite progress made with reconstruction, morbidity is still elevated after (pharyngo)laryngectomy. The present study was designed to determine the incidence and predisposing factors of the complications following (pharyngo)laryngectomy.

METHODS

Primary surgical treatment was delivered in 60 patients. Seventy-five patients underwent surgical salvage following radiotherapy. Different factors were evaluated as potentially predisposing to fistula formation.

RESULTS

Stenosis is rare: 5.1% in the present series. A pharyngocutaneous fistula developed in 48.8% of patients. After a multivariate analysis, the site of the tumour was defined as a significant risk factor for pharyngocutaneous fistula formation.

CONCLUSIONS

Despite progress made with reconstruction, morbidity is still elevated after major resection of the phary golarynx. Stenosis, a frequent complication when partial pharyngectomy is needed, is rare: 5.1% in the present series. Fistulas are relatively frequent but the majority resolved either with local irrigation or with subsequent flaps. The site of the tumour was a significant risk factor for pharyngocutaneous fistula formation, as defined by a multivariate analysis.

摘要

背景

尽管在重建方面取得了进展,但喉(咽)切除术后的发病率仍然较高。本研究旨在确定喉(咽)切除术后并发症的发生率和诱发因素。

方法

对60例患者进行了一期手术治疗。75例患者在放疗后接受了挽救性手术。对不同因素进行了评估,以确定其是否可能诱发瘘管形成。

结果

狭窄很少见:在本系列中为5.1%。48.8%的患者发生了咽皮肤瘘。多因素分析后,肿瘤部位被确定为咽皮肤瘘形成的一个重要危险因素。

结论

尽管在重建方面取得了进展,但下咽和喉部的大部分切除术后发病率仍然较高。狭窄是需要行部分咽切除时常见的并发症,在本系列中很少见:为5.1%。瘘管相对常见,但大多数通过局部冲洗或随后的皮瓣修复得以解决。多因素分析确定肿瘤部位是咽皮肤瘘形成的一个重要危险因素。

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