喉癌全喉切除术后咽瘘及手术切口感染的可能危险因素的影响:一项荟萃分析。
Effect of possible risk factors for pharyngocutaneous fistula after total laryngectomy of laryngeal carcinomas and surgical wound infection: A meta-analysis.
机构信息
Department of Otolaryngology Head and Neck Surgery, the Sixth Hospital of Wuhan, Wuhan, China.
Department of Otorhinolaryngology Head and Neck Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
出版信息
Int Wound J. 2023 Sep;20(7):2664-2672. doi: 10.1111/iwj.14140. Epub 2023 May 26.
A meta-analysis study to assess the effect of possible risk factors for pharyngocutaneous fistula (PCF) after total laryngectomy of laryngeal carcinoma. A comprehensive literature examination till January 2023 was implemented and 1794 linked studies were appraised. The picked studies contained 3140 subjects with total laryngectomy of laryngeal carcinomas in the picked studies' baseline, 760 of them were PCF, and 2380 were no PCF. Odds ratio (OR) in addition to 95% confidence intervals (CIs) were used to calculate the consequence of possible risk factors for PCF after total laryngectomy of laryngeal carcinomas and surgical wound infection after total laryngectomy of laryngeal carcinoma by the dichotomous and continuous styles and a fixed or random model. The PCF had a significantly higher surgical wound infection (OR, 6.34; 95% CI, 1.89-21.27, P = .003) compared with the no PCF in total laryngectomy of laryngeal carcinomas. The smoking (OR, 1.73; 95% CI, 1.15-2.61, P = .008), and preoperative radiation (OR, 1.90; 95% CI, 1.37-2.65, P < .001) had significantly higher PCF as a risk factor in total laryngectomy of laryngeal carcinomas. The preoperative radiation had a significantly lower spontaneous PCF closure (OR, 0.33; 95% CI, 0.14-0.79, P = .01) compared with the no preoperative radiation in total laryngectomy of laryngeal carcinomas. However, the neck dissection (OR, 1.34; 95% CI, 0.75-2.38, P = .32), and alcohol intake (OR, 1.95; 95% CI, 0.76-5.05, P = .17), had no significant effect on PCF in total laryngectomy of the PCF had a significantly higher surgical wound infection, and preoperative radiation had a significantly lower spontaneous PCF closure in total laryngectomy of laryngeal carcinomas. Smoking and preoperative radiation were shown to be risk factors for PCF, however, neck dissection and alcohol intake were not shown to be risk factors for PCF in total laryngectomy of laryngeal carcinomas. Although precautions should be taken when commerce with the consequences because some of the picked studies for this meta-analysis was with low sample sizes.
一项荟萃分析研究评估了喉癌全喉切除术后咽瘘(PCF)发生的可能危险因素。截至 2023 年 1 月,进行了全面的文献检查,并评估了 1794 项相关研究。这些研究包括 3140 名在研究基线时接受喉癌全喉切除术的患者,其中 760 例为 PCF,2380 例为非 PCF。使用优势比(OR)和 95%置信区间(CI),按二项式和连续式,采用固定或随机模型,计算喉癌全喉切除术后可能危险因素及喉癌全喉切除术后手术切口感染的结果。与无 PCF 相比,PCF 的手术切口感染明显更高(OR,6.34;95%CI,1.89-21.27,P=0.003)。吸烟(OR,1.73;95%CI,1.15-2.61,P=0.008)和术前放疗(OR,1.90;95%CI,1.37-2.65,P<0.001)是喉癌全喉切除术后发生 PCF 的危险因素。与术前未接受放疗相比,术前放疗的自发性 PCF 闭合率显著降低(OR,0.33;95%CI,0.14-0.79,P=0.01)。然而,颈部解剖(OR,1.34;95%CI,0.75-2.38,P=0.32)和饮酒(OR,1.95;95%CI,0.76-5.05,P=0.17)对 PCF 无显著影响。喉癌全喉切除术后,PCF 手术切口感染明显较高,术前放疗后 PCF 自发性闭合明显降低。吸烟和术前放疗是 PCF 的危险因素,但颈部解剖和饮酒不是喉癌全喉切除术后 PCF 的危险因素。尽管由于本次荟萃分析的一些纳入研究样本量较小,在考虑这些结果时应谨慎,但还是应该采取预防措施。