Ming Wei, Hua Qingquan, Zhan Hanzhang
Department of Otolaryngology-Head and Neck Surgery, People's Hospital of Wuhan University, Wuhan, 430060, China.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2008 Jun;22(12):542-3.
To investigate the locations, predisposing factors, managements and outcomes of pharyngocutaneous fistula (PCF) following total laryngectomy in patients with advanced stage hypopharyngeal or laryngeal carcinomas.
One hundred and ninety-eight patients with advanced hypopharyngeal or laryngeal carcinomas who were performed by total laryngectomy were analyzed retrospectively. The multiple predisposing factors, including age, sex, preoperative radiotherapy, previous tracheostomy, stage, differentiation, site, neck dissection and postoperative fever, were analyzed.
The incidence of PCF was 16.7%. The situations of orificium fistulae lied in 69.7% superior segment, 21.2% inferior and 9.1% middle segment respectively. The incidence of PCF was 24.7% in hypopharynx and 11.6% in larynx respectively. There were significant differences between them. The differences of postoperative continuous fever beyond 5 days were statistical significance between the group of PCF and no PCF. In them, 28 patients of PCF were healed spontaneously and 5 of them were healed by surgical operation.
PCF is often situated in tongue base and post-superior of trachea stoma. Tumor locations and postoperative fever are important predisposition.
探讨晚期下咽癌或喉癌患者全喉切除术后咽瘘（PCF）的发生部位、诱发因素、处理方法及预后。
回顾性分析198例行全喉切除术的晚期下咽癌或喉癌患者。分析多种诱发因素，包括年龄、性别、术前放疗、既往气管切开、分期、分化程度、部位、颈部淋巴结清扫及术后发热情况。
咽瘘发生率为16.7%。瘘口情况分别为上段占69.7%，下段占21.2%，中段占9.1%。下咽癌患者咽瘘发生率为24.7%，喉癌患者为11.6%，两者有显著差异。咽瘘组与无咽瘘组术后持续发热超过5天的差异有统计学意义。其中，28例咽瘘患者自行愈合，5例经手术愈合。
咽瘘常位于舌根及气管造口后上方。肿瘤部位及术后发热是重要的诱发因素。
