Department of Otolaryngology–Head and Neck Surgery, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada.
J Otolaryngol Head Neck Surg. 2012 Jun 1;41(3):169-75.
This article considers whether preoperative tracheostomy and primary tracheoesophageal puncture (TEP) contribute as independent risk factors to the development of pharyngocutaneous fistula (PCF), as well as discusses the significant factors related to the perioperative management of these patients.
Retrospective data were collected on 145 patients treated with total laryngectomy/pharyngolaryngectomy between January 2003 and July 2010 at the Victoria Hospital in London, Ontario, including whether preoperative tracheostomy or primary TEP was performed.
One in four (25%) patients developed a postoperative PCF. No increase in PCF rates was observed with either preoperative tracheostomy or primary TEP. Salvage surgery PCFs achieved lower rates of spontaneous closure compared to those undergoing primary surgery (p = .002).
Neither preoperative tracheostomy nor primary TEP was associated with the development of PCF. Surgical closure of PCF is more likely to be required in the setting of salvage surgery.
本文探讨了术前气管切开术和原发性气管食管造口术（TEP）是否作为独立的危险因素导致咽皮瘘（PCF）的发生，并讨论了与这些患者围手术期管理相关的重要因素。
回顾性收集了 2003 年 1 月至 2010 年 7 月在安大略省伦敦市维多利亚医院接受全喉切除术/咽喉切除术治疗的 145 例患者的数据，包括是否进行了术前气管切开术或原发性 TEP。
四分之一（25%）的患者术后发生咽皮瘘。术前气管切开术或原发性 TEP 均未增加咽皮瘘的发生率。与初次手术相比，挽救性手术的咽皮瘘自发闭合率较低（p =.002）。
术前气管切开术和原发性 TEP 均与咽皮瘘的发生无关。在挽救性手术中，更可能需要手术闭合咽皮瘘。
