Risk factors for pharyngocutaneous fistula formation: a study focused on pharyngeal reconstruction technique.

IF 1.1 4区医学 Q3 OTORHINOLARYNGOLOGY

Journal of Laryngology and Otology Pub Date : 2025-02-01 Epub Date: 2024-10-21 DOI:10.1017/S0022215124001415

Yagmur Barcan, Yalcin Alimoglu, Gokhan Gurbuz, Omer Uysal

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Abstract

Objective: This study investigated the risk factors for developing pharyngocutaneous fistula, the most common complication following total laryngectomy.

Methods: We included all patients who underwent total laryngectomy and bilateral neck dissection from 2009 to 2021. Patients excluded were those with hypopharyngeal involvement, total or partial pharyngectomy, base of the tongue resection, large pharyngeal defects requiring free/pedicle flap reconstruction, or salvage laryngectomy.

Results: A total of 164 patients participated in the study. Multivariate regression analysis identified two independent predictors of pharyngocutaneous fistula formation: pharyngeal reconstruction with simple interrupted sutures (odds ratio: 3.12, 95 per cent confidence interval: 1.31-17.00, p = 0.010) and radical neck dissection (odds ratio: 3.16, 95 per cent confidence interval: 1.13-8.82, p = 0.028).

Conclusions: Our findings suggest that pharyngeal reconstruction using simple interrupted sutures and radical neck dissection are independent risk factors for pharyngocutaneous fistula development. Based on this, we recommend using the modified Cushing suture technique over simple interrupted sutures due to its association with a significantly lower pharyngocutaneous fistula rate.

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咽瘘形成的风险因素：以咽部重建技术为重点的研究

目的：探讨喉全切除术后最常见的并发症咽皮瘘发生的危险因素。方法：我们纳入了2009年至2021年所有接受全喉切除术和双侧颈部清扫的患者。排除的患者包括下咽受累、全部或部分咽切除术、舌底切除术、需要自由/蒂瓣重建的大面积咽缺损或保留性喉切除术。结果：共164例患者参与研究。多因素回归分析确定了咽皮瘘形成的两个独立预测因素：简单中断缝合咽重建（优势比：3.12,95%可信区间：1.31-17.00,p = 0.010）和根治性颈部清扫（优势比：3.16,95%可信区间：1.13-8.82,p = 0.028）。结论：我们的研究结果表明，使用简单的中断缝合和根治性颈部清扫进行咽重建是咽皮瘘发生的独立危险因素。基于此，我们建议使用改良的库欣缝合技术，而不是简单的中断缝合，因为它与显著降低咽皮瘘率有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Laryngology and Otology 医学-耳鼻喉科学

CiteScore

3.20

自引率

11.80%

发文量

593

审稿时长

3-6 weeks

期刊介绍： The Journal of Laryngology & Otology (JLO) is a leading, monthly journal containing original scientific articles and clinical records in otology, rhinology, laryngology and related specialties. Founded in 1887, JLO is absorbing reading for ENT specialists and trainees. The journal has an international outlook with contributions from around the world, relevant to all specialists in this area regardless of the country in which they practise. JLO contains main articles (original, review and historical), case reports and short reports as well as radiology, pathology or oncology in focus, a selection of abstracts, book reviews, letters to the editor, general notes and calendar, operative surgery techniques, and occasional supplements. It is fully illustrated and has become a definitive reference source in this fast-moving subject area. Published monthly an annual subscription is excellent value for money. Included in the subscription is access to the JLO interactive web site with searchable abstract database of the journal archive back to 1887.