Šifrer Robert, Strojan Primož, Tancer Ivana, Dolenc Maja, Fugina Simon, Zore Sara Bitenc, Aničin Aleksandar
Department of Otorhinolaryngology and Cervicofacial Surgery, University Medical Centre Ljubljana, Zaloška 2, 1000 Ljubljana, Slovenia.
Faculty of Medicine, University of Ljubljana, Vrazov trg 2, 1000 Ljubljana, Slovenia.
Cancers (Basel). 2023 Apr 12;15(8):2246. doi: 10.3390/cancers15082246.
The pharyngocutaneous fistula (PCF) is the most common complication following a total laryngectomy (TL) with a wide range of incidence and various potential risk factors. The aim was to analyse the incidence and potential risk factors for PCF formation in a large study set collected over a longer period of time. In the retrospective study at the Department of Otorhinolaryngology and Cervicofacial Surgery of Ljubljana, 422 patients who were treated for head and neck cancer by TL between 2007 and 2020 were included. The comprehensive clinicopathologic data were collected including potential risk factors related to the patient, disease, surgical treatment and post-operative period for the development of fistulae. The patients were categorized into a group with the fistula (a study group) and one without it (a control group). The PCF then developed in 23.9% of patients. The incidence following a primary TL was 20.8% and 32.7% following salvage TL ( = 0.012). The results demonstrated that surgical wound infection, piriform sinus invasion, salvage TL, and total radiation dose were determined as independent risk factors for PCF formation. A diminishing surgical wound infection rate would contribute to a further reduction of the PCF rate.
咽皮肤瘘（PCF）是全喉切除术（TL）后最常见的并发症，其发生率范围广泛且存在多种潜在风险因素。目的是在较长时间内收集的大量研究数据集中分析PCF形成的发生率和潜在风险因素。在卢布尔雅那耳鼻咽喉头颈外科进行的一项回顾性研究中，纳入了2007年至2020年间接受TL治疗头颈癌的422例患者。收集了全面的临床病理数据，包括与患者、疾病、手术治疗以及术后发生瘘管相关的潜在风险因素。将患者分为有瘘管组（研究组）和无瘘管组（对照组）。然后，23.9%的患者发生了PCF。初次TL后的发生率为20.8%，挽救性TL后为32.7%（P = 0.012）。结果表明，手术伤口感染、梨状窝侵犯、挽救性TL和总放射剂量被确定为PCF形成的独立风险因素。降低手术伤口感染率将有助于进一步降低PCF发生率。
