全喉切除术后的“瘘管零号”项目：坎迪奥洛癌症研究所的经验
"Fistula Zero" Project After Total Laryngectomy: The Candiolo Cancer Institute Experience.
作者信息
Crosetti Erika, Arrigoni Giulia, Sprio Andrea Elio, Succo Giovanni
机构信息
Head and Neck Oncology Unit, Candiolo Cancer Institute, Fondazione del Piemonte per l'Oncologia - IRCCS (FPO-IRCCS), Candiolo, Italy.
Department of Biomedical and Clinic Sciences, University of Turin, Orbassano, Italy.
出版信息
Front Oncol. 2021 Jun 22;11:690703. doi: 10.3389/fonc.2021.690703. eCollection 2021.
OBJECTIVES
Pharyngocutaneous fistula (PCF) is a troublesome complication after total laryngectomy. The "Fistula zero" project aims to reduce the number of PCF by following a detailed protocol based on three fundamental key points.
MATERIALS AND METHODS
The Fistula zero project included 77 patients who underwent total laryngectomy in the period from January 2019 to December 2020. The protocol consisted of three main aspects: the systematic placement of a Har-El salivary bypass tube, the continuous horizontal watertight pharyngeal suture using a barbed suture, onlay insetting of a pedicled flap in pre-treated patients.
RESULTS
One case of PCF (1.3%) and three small blind fistulas (3.9%) were observed in this series. The mean length of hospitalization was 18 days.
CONCLUSION
Pharyngocutaneous fistula (PCF) prolongs hospitalization and delays adjuvant treatments. Thanks to a strict adherence to the protocol, it was possible to reduce PCF rates, avoiding lengthy hospitalization and additional surgical procedures.
目的
咽皮肤瘘（PCF）是全喉切除术后令人困扰的并发症。“零瘘管”项目旨在通过遵循基于三个基本要点的详细方案来减少PCF的数量。
材料与方法
“零瘘管”项目纳入了2019年1月至2020年12月期间接受全喉切除术的77例患者。该方案包括三个主要方面：系统放置Har-El唾液分流管、使用倒刺缝线进行连续水平的咽壁水密缝合、对预处理患者进行带蒂皮瓣覆盖植入。
结果
本系列中观察到1例PCF（1.3%）和3例小的盲端瘘（3.9%）。平均住院时间为18天。
结论
咽皮肤瘘（PCF）延长住院时间并延迟辅助治疗。由于严格遵守该方案，有可能降低PCF发生率，避免长时间住院和额外的手术操作。
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