Pharyngocutaneous fistula after total laryngectomy

DOI 5 Citations 26 References
  • Nakanishi Yosuke
    Division of Otolaryngology, Head and Neck Surgery, Graduate School of Medicine, Kanazawa University
  • Wakisaka Naohiro
    Division of Otolaryngology, Head and Neck Surgery, Graduate School of Medicine, Kanazawa University
  • Murono Shigeyuki
    Division of Otolaryngology, Head and Neck Surgery, Graduate School of Medicine, Kanazawa University
  • Kondo Satoru
    Division of Otolaryngology, Head and Neck Surgery, Graduate School of Medicine, Kanazawa University
  • Yoshizaki Tomokazu
    Division of Otolaryngology, Head and Neck Surgery, Graduate School of Medicine, Kanazawa University

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Other Title
  • 喉頭全摘術後の咽頭皮膚瘻の発生

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Objectives: We evaluated the cause and the duration of pharyngocutaneous fistula (PCF) after laryngectomy, placing special emphasis on radiotherapy and/or chemotherapy.<br>Patients and methods: A total of 78 consecutive patients undergoing salvage total laryngectomy for squamous cell carcinoma of the larynx at Kanazawa University Hospital from 1990 to 2008 were reviewed. Forty-three of 78 had received primary total laryngectomy (PL). Sixteen patients underwent radiotherapy alone (SL-RT) and nine patients underwent concurrent systemic chemoradiotherapy (SL-SCRT1, 10 patients underwent concurrent arterio chemoradiotherapy (SL-ACRT) followed by salvage laryngectomy.<br>Results: Overall, 23 of the 78 patients (29.4%) developed PCF after laryngectomy. Fisher's exact test showed a significant increase of PCF formation in salvage laryngectomy (45%) compared with PL (16%) (p = 0.0046). The Mann-Whitney U-test showed that the duration of PCF was significantly longer for SL (89.1 ± 104.2 days) compared with those for PL (54.9 ± 50.9 days) (p = 0.0146). Although we did not find a significant difference in the duration of PCF with respect to SL-SCRT and SL-ACRT (p = 0.1084), there were longer durations of PCF in SL-ACRT (143.8 ± 84.3 days) than SL-SCRT (41.4 ± 14.4 days).<br>Conclusions: Radiotherapy has an impact on PCF information. Both radiotherapy and chemotherapy have an impact on PCF closure. We supposed that the dose of drug in the irradiation tissue has impact on PCF closure.

Journal

  • Toukeibu Gan

    Toukeibu Gan 36 (1), 48-52, 2010

    Japan Society for Head and Neck Cancer

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