Başkadem Yilmazer Ayça, Aksungur Elif, Çelik Cem, Bayram Avni Akin, Turgut Hüseyin, Dinç Mehmet Emre, Göker Ayşe Enise, Uyar Yavuz
Prof Dr Cemil Tascıoglu Hospital, Department of Otorhinolaryngology, University of Saglik Bilimleri, Istanbul, Turkey.
Clin Otolaryngol. 2025 Jan;50(1):122-127. doi: 10.1111/coa.14247. Epub 2024 Oct 19.
Pharyngocutaneous fistula (PCF) is one of the most challenging complications observed after a total laryngectomy. Since the biochemical components of platelet-rich fibrin (PRF) have well-known synergistic effects on the healing processes, this study aimed to demonstrate the contribution of PRF application to pharyngeal healing in patients undergoing a total laryngectomy for laryngeal cancer.
The study compared patients who underwent a total laryngectomy due to laryngeal squamous cell carcinoma and had a PRF membrane placed during the pharyngoesophageal closure with those who did not. There were two groups: PRF-positive and PRF-negative. In the PRF-positive group, after the completion of the total laryngectomy and moving on to the pharyngoesophageal closure stage, along the suture line, PRF material is laid in two pieces in a T-shape and secured with several sutures. No PRF application was done in the PRF-negative group. Pharyngeal healing steps (nasogastric feeding, oral feeding, development of a fistula), haemoglobin and albumin values, tumour involvement areas, time to oral intake and length of hospital stay were recorded for all patients.
This study reviewed the records of 33 patients who underwent pharyngoesophageal closure with PRF application after a total laryngectomy (PRF-positive group) and 35 patients without PRF application (PRF-negative group). When comparing patients in terms of developing a PCF, 6% (n = 2) of patients in the PRF-positive group and 25.7% (n = 9) in the PRF-negative group developed a fistula. This ratio was significantly higher in the PRF-negative group (p = 0.027).
The application of PRF in pharyngoesophageal reconstruction after a total laryngectomy may strengthen wound healing and reduce the risk of PCF development.
This study is a retrospective designed study; therefore, there is no clinical trial registration.
咽皮肤瘘（PCF）是全喉切除术后最具挑战性的并发症之一。由于富血小板纤维蛋白（PRF）的生化成分对愈合过程具有众所周知的协同作用，本研究旨在证明PRF应用对因喉癌接受全喉切除术患者的咽部愈合的贡献。
本研究比较了因喉鳞状细胞癌接受全喉切除术且在咽食管闭合时放置PRF膜的患者与未放置的患者。分为两组：PRF阳性组和PRF阴性组。在PRF阳性组中，全喉切除完成并进入咽食管闭合阶段后，沿缝合线将PRF材料呈T形分成两片放置，并用几根缝线固定。PRF阴性组未应用PRF。记录所有患者的咽部愈合步骤（鼻饲、经口进食、瘘的形成）、血红蛋白和白蛋白值、肿瘤累及区域、经口进食时间和住院时间。
本研究回顾了33例全喉切除术后应用PRF进行咽食管闭合的患者（PRF阳性组）和35例未应用PRF的患者（PRF阴性组）的记录。在比较发生PCF的患者时，PRF阳性组中有6%（n = 2）的患者发生了瘘，PRF阴性组中有25.7%（n = 9）的患者发生了瘘。PRF阴性组的这一比例明显更高（p = 0.027）。
全喉切除术后在咽食管重建中应用PRF可能会加强伤口愈合并降低发生PCF的风险。
本研究是一项回顾性设计研究；因此，没有临床试验注册。
