Department of Sense Organs, University Sapienza of Rome, Italy.
Department of Oral and Maxillo-Facial Surgery, University Sapienza of Rome, Italy.
Ear Nose Throat J. 2022 Aug;101(7):463-467. doi: 10.1177/0145561320961754. Epub 2020 Oct 12.
One of the most common complications in the immediate and late postoperative period following total laryngectomy or pharyngolaryngectomy is pharyngocutaneous fistulae (PCF) formation and pharyngoesophageal stenosis (PES), causing significant mortality and morbidity. Since 1978, Montgomery salivary bypass tube (MSBT) has been used to reduce the incidence of PCF and PES. The aim of this retrospective study was to analyze the outcomes of using MSBT both as a tool to prevent PCF and PES and to treat these complications in the postoperative period.
Between January 2013 and December 2019, we inserted 109 MSBT in 87 patients with laryngeal/hypopharyngeal cancer treated in the Unit of Otolaryngology of our University Hospital.
Sixty (86.9%) patients healed from complications with primary and secondary placement of MSBT. Seven patients presented a persistence of PCF and 2 presented a recurrence of PES. Secondary placement of MSBT allowed treating successfully 15 (83%) of 18 patients. Only 3 of them presented a PCF at the end of the follow-up period.
According to our experience, the MSBT is an affordable, easy to apply and well-tolerated tool. Although it is generally used for PCF treatment, it can also be used intraoperatively for PCF and PES prevention.
全喉切除术或咽-喉切除术术后即刻和晚期最常见的并发症之一是咽-皮肤瘘（PCF）形成和咽食管狭窄（PES），导致显著的死亡率和发病率。自 1978 年以来，蒙哥马利涎管旁路管（MSBT）已被用于降低 PCF 和 PES 的发生率。本回顾性研究旨在分析 MSBT 作为预防 PCF 和 PES 以及治疗术后这些并发症的工具的效果。
在 2013 年 1 月至 2019 年 12 月期间，我们在我们大学医院的耳鼻喉科单位治疗了 87 例喉/下咽癌患者，共插入了 109 根 MSBT。
60（86.9%）例患者通过 MSBT 的初次和二次放置治愈了并发症。7 例患者出现持续性 PCF，2 例患者出现 PES 复发。MSBT 的二次放置成功治疗了 18 例患者中的 15 例（83%）。其中只有 3 例在随访期末出现 PCF。
根据我们的经验，MSBT 是一种经济实惠、易于应用且耐受性良好的工具。尽管它通常用于治疗 PCF，但它也可以在手术中用于预防 PCF 和 PES。
