Complicated pharyngocutaneous fistula repair after head and neck cancer surgery: a case series of 7 patients.

IF 1.8 3区医学 Q2 SURGERY

BMC Surgery Pub Date : 2025-10-09 DOI:10.1186/s12893-025-03223-x

Weihua Zhou, Huajun Feng, Sai Liang, Shengen Xu, Zhuoping Liang, Yuanyuan Wang, Gang Qin

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Abstract

Objective: To retrospectively analyze the repair of seven cases of complicated pharyngocutaneous fistula (PCF) to provide a reference for the treatment of complicated PCF.

Methods: We retrospectively analyzed the clinical data of seven patients with complicated PCF from February 2017 to December 2021, including six males and one female, with a history of neck radiotherapy in two cases. The range of PCF mucosal defects was 1.0 cm × 2.0-5.0 cm × 7.0 cm. A pedicled flap or free flap was chosen for repair depending on the site and size of the defect. A total of eight flaps were used to repair complicated PCF defects.

Results: One of the seven patients healed after conservative treatment. Among the five patients who underwent pedicled flap repair, three had first-intention healing, one had second-intention healing, and one had tumor recurrence with unhealed PCF. Free flap repair was performed in one case, which had first-intention healing.

Conclusion: Early, prompt, and appropriate treatment can prevent a PCF from progressing to complicated PCF. The repair of the complicated PCF needs to be individualized according to the patient's local defect and the surgeon's clinical experience.

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头颈癌术后复杂咽皮瘘修复：附7例报告。

目的：回顾性分析7例复杂咽皮瘘（PCF）的修复方法，为复杂咽皮瘘的治疗提供参考。方法：回顾性分析2017年2月至2021年12月7例合并PCF患者的临床资料，其中男6例，女1例，其中2例有颈部放疗史。PCF粘膜缺损范围为1.0 cm × 2.0 ~ 5.0 cm × 7.0 cm。根据缺损的部位和大小，选择带蒂皮瓣或自由皮瓣进行修复。共使用8个皮瓣修复复杂的PCF缺损。结果：7例患者经保守治疗后1例痊愈。在5例行带蒂皮瓣修复的患者中，3例首次愈合，1例二次愈合，1例肿瘤复发并未愈合的PCF。游离皮瓣修复1例，一期愈合。结论：早期、及时、适当的治疗可防止PCF发展为复杂的PCF。复杂PCF的修复需要根据患者的局部缺陷和外科医生的临床经验进行个体化治疗。

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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