全喉切除术后咽皮肤瘘：危险因素的系统评价
Pharyngocutaneous fistula after total laryngectomy: systematic review of risk factors.
作者信息
Dedivitis Rogério Aparecido, Aires Felipe Toyama, Cernea Claudio Roberto, Brandão Lenine Garcia
机构信息
Department of Head and Neck Surgery, Hospital das Clínicas, University of São Paulo School of Medicine, São Paulo, Brazil.
Department of General Surgery, Hospital Ana Costa, Santos, Brazil.
出版信息
Head Neck. 2015 Nov;37(11):1691-7. doi: 10.1002/hed.23804. Epub 2015 Jun 26.
BACKGROUND
Pharyngocutaneous fistula (PCF) is the most common surgical complication after total laryngectomy. Controversy still remains regarding the multiple risk factors implicated. The purpose of this study was to evaluate the potential risk factors for PCF.
METHODS
The strategy for our literature survey included research in MEDLINE up to December 2013. The risk factors analyzed were age, sex, smoking habit, alcohol use, comorbidity, preoperative hemoglobin level, blood transfusion, preoperative tracheotomy, previous radiotherapy and chemoradiotherapy, primary tumor site, T classification, cartilage invasion, tumor grade, surgical margins, suture material, second layer of suture, reconstruction, tracheoesophageal prosthesis, and neck dissection.
RESULTS
The electronic search resulted in 311 studies from which 63 met the inclusion criteria.
CONCLUSION
Chronic obstructive pulmonary disease (COPD), previous hemoglobin <12.5g/dL, blood transfusion, previous radiotherapy or chemoradiotherapy, advanced primary tumors, supraglottic subsite, hypopharyngeal tumor site, positive surgical margins, and the performance of neck dissection were risk factors for PCF.
背景
咽皮肤瘘（PCF）是全喉切除术后最常见的手术并发症。对于与之相关的多种危险因素仍存在争议。本研究的目的是评估PCF的潜在危险因素。
方法
我们的文献检索策略包括检索截至2013年12月的MEDLINE数据库。分析的危险因素包括年龄、性别、吸烟习惯、饮酒情况、合并症、术前血红蛋白水平、输血、术前气管切开术、既往放疗和放化疗、原发肿瘤部位、T分级、软骨侵犯、肿瘤分级、手术切缘、缝合材料、第二层缝合、重建、气管食管假体以及颈部清扫术。
结果
电子检索得到311项研究，其中63项符合纳入标准。
结论
慢性阻塞性肺疾病（COPD）、既往血红蛋白<12.5g/dL、输血、既往放疗或放化疗、晚期原发肿瘤、声门上亚部位、下咽肿瘤部位、手术切缘阳性以及颈部清扫术的实施是PCF的危险因素。
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