Soylu L, Kiroglu M, Aydogan B, Cetik F, Kiroglu F, Akçali C, Ozşahinoglu C
Department of Otolaryngology, Cukurova University Medical Faculty, Adana, Turkey.
Head Neck. 1998 Jan;20(1):22-5. doi: 10.1002/(sici)1097-0347(199801)20:1<22::aid-hed4>3.0.co;2-5.
Pharyngocutaneous fistula (PCF) following laryngectomy is a serious complication, and its incidence varies from 7.6% to 50%. Despite the relative frequency of this complication, there is still uncertainty about the predisposing factors.
A retrospective study was performed in 295 patients who underwent total laryngectomy.
Of the 295 patients, 37 (12.5%) developed PCF. The contributing factors,--such as early oral feeding postoperatively, prior radiotherapy or tracheostomy, accompanying neck dissection,--and the surgical technique failed to show a statistically significant effect. There was statistically significant association between tumor size and PCF formation. Also, when the suture materials used for the closure of the pharynx were compared, catgut showed a higher rate of PCF formation than vicryl (p < .05).
The vicryl, when used as a suture material for the closure of the pharynx, seemed to decrease the fistula rate significantly, compared with catgut. Also, tumor stage was found to have a significant role in PCF formation, but no statistical significant difference could be demonstrated for other investigated parameters. We believe that after total laryngectomy, oral feeding can be started at the third postoperative day without increasing morbidity, which makes the patients feel more comfortable and confident without nasogastric tube.
喉切除术后咽皮肤瘘（PCF）是一种严重的并发症，其发生率在7.6%至50%之间。尽管这种并发症相对常见，但关于其诱发因素仍存在不确定性。
对295例行全喉切除术的患者进行了一项回顾性研究。
在295例患者中，37例（12.5%）发生了PCF。术后早期经口进食、既往放疗或气管切开、同期颈部淋巴结清扫等相关因素以及手术技术均未显示出统计学上的显著影响。肿瘤大小与PCF形成之间存在统计学上的显著关联。此外，在比较用于关闭咽部的缝合材料时，肠线显示出比薇乔线更高的PCF形成率（p < 0.05）。
与肠线相比，薇乔线用作关闭咽部的缝合材料时，似乎能显著降低瘘管发生率。此外，发现肿瘤分期在PCF形成中起重要作用，但其他研究参数未显示出统计学上的显著差异。我们认为，全喉切除术后，术后第三天即可开始经口进食而不增加发病率，这使患者在无鼻胃管的情况下感觉更舒适和自信。
