全喉切除术后咽皮肤瘘
[Pharyngocutaneous fistula following total laryngectomy].
作者信息
Aires Felipe Toyama, Dedivitis Rogério Aparecido, Castro Mario Augusto Ferrari de, Ribeiro Daniel Araki, Cernea Claudio Roberto, Brandão Lenine Garcia
机构信息
Lusíada University Center in Santos, Rua Dr. Olinto Rodrigues Dantas, no. 343, Encruzilhada. Santos - SP, Brazil.
出版信息
Braz J Otorhinolaryngol. 2012 Dec;78(6):94-8. doi: 10.5935/1808-8694.20120040.
UNLABELLED
Pharyngocutaneous fistula (PCF) is the most common complication after total laryngectomy.
OBJECTIVES
To establish the incidence of this complication and to analyze the predisposing factors.
METHOD
This is a cross-sectional study of a historical cohort including 94 patients who underwent total laryngectomy. The following aspects were correlated to the occurrence of PCF: gender, age, tumor site, TNM staging, type of neck dissection, previous radiation therapy, previous tracheotomy, and use of stapler for pharyngeal closure. The following were considered in PCF cases: the day into postoperative care when the fistula was diagnosed, duration of occurrence, and proposed treatment.
RESULTS
Twenty (21.3%) patients had PCF. The incidence of PCF was statistically higher in T4 tumors when compared to T2 and T3 neoplasms ( = 0.03). The other analyzed correlations were not statistically significant. However, 40.9% of the patients submitted to tracheostomy previously had fistulae, against 21.1% of the patients not submitted to this procedure.
CONCLUSION
Advanced primary tumor staging is correlated with higher incidences of PCF.
未标注
咽皮肤瘘（PCF）是全喉切除术后最常见的并发症。
目的
确定该并发症的发生率并分析相关危险因素。
方法
这是一项对94例行全喉切除术患者的历史队列横断面研究。将以下因素与PCF的发生进行关联分析：性别、年龄、肿瘤部位、TNM分期、颈部清扫类型、既往放疗史、既往气管切开史以及咽部闭合时使用吻合器的情况。对于PCF病例，还考虑了瘘管诊断时进入术后护理的天数、发生持续时间以及建议的治疗方法。
结果
20例（21.3%）患者发生了PCF。与T2和T3肿瘤相比，T4肿瘤患者的PCF发生率在统计学上更高（ = 0.03）。其他分析的相关性无统计学意义。然而，既往行气管切开术的患者中有40.9%发生了瘘管，而未行该手术的患者中这一比例为21.1%。
结论
原发肿瘤分期越晚，PCF的发生率越高。
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