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全喉切除术后咽修复时间和缝合频率对咽皮肤瘘发生的影响。

The impact of pharyngeal repair time and suture frequency on the development of pharyngocutaneous fistula after total laryngectomy.

作者信息

Aydin Salih, Taskin Umit, Orhan Israfil, Altas Bengül, Ege Sertuğ Sinan, Yucebas Kadir, Oktay Mehmet Faruk

机构信息

From the *Department of Otorhinolaryngology, Bagcilar Education and Research Hospital, Istanbul; and †Department of Otorhinolaryngology, Medical Park Hospital, Elazig, Turkey.

出版信息

J Craniofac Surg. 2014 May;25(3):775-9. doi: 10.1097/SCS.0000000000000826.

Abstract

OBJECTIVE

Pharyngocutaneous fistula (PCF) is the most common postoperative complication after total laryngectomy. The aim of this study was to determine the relationship between PCF with pharyngeal repair time and the number of mucosal sutures.

METHODS

The medical records of 47 patients who underwent total laryngectomy were assessed prospectively. The pharyngeal repair time and the number of horizontal, vertical, and cricopharyngeal muscle sutures were recorded. We observed the occurrence of PCF in 14 patients (29.8%). The mean time for pharyngeal repair in the PCF group was 22 minutes 59 seconds ± 5 minutes, and the mean number of vertical, horizontal, and cricopharyngeal muscle sutures was 8.57 ± 2.6, 11.14 ± 2.1, and 8.45 ± 1.9, respectively. The mean time for pharyngeal repair in the non-PCF group was 22 minutes 21 seconds ± 5 minutes, and the mean number of vertical, horizontal, and cricopharyngeal muscle sutures was 9.54 ± 2.6, 10.84 ± 2.3, and 7.36 ± 2.7, respectively. The differences in the pharyngeal repair time and the number of vertical, horizontal, and cricopharyngeal sutures between the 2 groups were not statistically significant (P > 0.05). Besides, there was no statistically significant difference between the mean suture counts per centimeter in horizontal plane (1.46 ± 0.35) and vertical plane (0.98 ± 0.25) in the PCF group and the mean suture counts per centimeter in horizontal plane (1.42 ± 0.37) and vertical plane (1.13 ± 0.3) in the non-PCF group (P > 0.05).

CONCLUSIONS

There was no relation between PCF development with pharyngeal repair time, mucosal suture count, and suture frequency after total laryngectomy.

摘要

目的

咽皮肤瘘(PCF)是全喉切除术后最常见的术后并发症。本研究的目的是确定PCF与咽修复时间及黏膜缝合针数之间的关系。

方法

对47例行全喉切除术患者的病历进行前瞻性评估。记录咽修复时间以及水平、垂直和环咽肌的缝合针数。我们观察了14例患者(29.8%)发生PCF的情况。PCF组咽修复的平均时间为22分59秒±5分钟,垂直、水平和环咽肌的平均缝合针数分别为8.57±2.6、11.14±2.1和8.45±1.9。非PCF组咽修复的平均时间为22分21秒±5分钟,垂直、水平和环咽肌的平均缝合针数分别为9.54±2.6、10.84±2.3和7.36±2.7。两组之间咽修复时间以及垂直、水平和环咽缝合针数的差异无统计学意义(P>0.05)。此外,PCF组水平平面(1.46±0.35)和垂直平面(0.98±0.25)每厘米的平均缝合针数与非PCF组水平平面(1.42±0.37)和垂直平面(1.13±0.3)每厘米的平均缝合针数之间无统计学意义(P>0.05)。

结论

全喉切除术后PCF的发生与咽修复时间、黏膜缝合针数及缝合频率无关。

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