改良垂直加压绷带预防喉全切除术后咽皮瘘。

IF 1.7 4区医学 Q2 OTORHINOLARYNGOLOGY

Brazilian Journal of Otorhinolaryngology Pub Date : 2025-01-03 DOI:10.1016/j.bjorl.2024.101537

Xuwei Duan , Jian Xu , Xueqin Liu , Duoping Wang , Biaoyou Chen

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引用次数: 0

摘要

目的：咽皮瘘（PCF）是全喉切除术（TLE）术后最常见和最具挑战性的并发症之一。本研究旨在评估改良垂直加压绷带（VPB）对头颈部（H&N）癌全喉切除术（TLE）后咽皮瘘（PCF）发生的影响。方法：本回顾性研究纳入2010年1月至2021年1月在我院接受TLE治疗的H&N癌患者。根据术后是否使用改良VPB对患者进行分组。主要结局是PCF的发生。次要观察指标为手术至PCF的时间间隔、PCF的愈合时间和住院时间。结果：133例患者：VPB组82例（年龄57.93±10.18岁，男性80例），常规组51例（年龄54.98±9.22岁，男性51例）。与未接受改良VPB的患者相比，接受改良VPB的患者PCF发生率显著降低（9.8% vs. 33.3%, p = 0.001）。此外，VPB组患者从手术到PCF的时间间隔（p = 0.374）和PCF的愈合时间（p = 0.256）相似，但住院时间明显缩短(p)。结论：改良VPB可减少H&N肿瘤TLE后PCF的发生。证据等级：四级。

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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A modified vertical pressure bandage to prevent pharyngocutaneous fistula after total laryngectomy

Objective

Pharyngocutaneous Fistula (PCF) is one of the most common and challenging postoperative complications after Total Laryngectomy (TLE). This study aimed to evaluate the impact of the modified Vertical Pressure Bandage (VPB) on the occurrence of Pharyngocutaneous Fistula (PCF) after Total Laryngectomy (TLE) for Head and Neck (H&N) cancer.

Methods

This retrospective study included patients with H&N cancer who underwent TLE at our hospital between January 2010 and January 2021. The patients were grouped according to whether modified VPB was used or not after surgery. The primary outcome was the occurrence of PCF. The secondary outcomes were the interval from operation to PCF, the healing time of PCF, and the length of hospital stay.

Results

This study included 133 patients: 82 (aged 57.93 ± 10.18 years, 80 males) in the VPB group and 51 (aged 54.98 ± 9.22 years, 51 males) in the conventional group. Patients who received the modified VPB had a significantly lower occurrence of PCF compared with those did not (9.8% vs. 33.3%, p = 0.001). In addition, the patients in the VPB group had similar interval from the operation to the PCF (p = 0.374) and healing time of PCF (p = 0.256) but a significantly shorter length of hospital stay (p < 0.001) compared with those in conventional group. Moreover, multivariable logistic regression analysis showed that, after adjusting for age, preoperative radiotherapy, postoperative hematocrit < 35%, VPB (RR = 0.165, 95% CI 0.057‒0.474, p = 0.001) was an independent protective factor for PCF.

Conclusion

The modified VPB might reduce the occurrence of PCF after TLE for H&N cancers.

Level of evidence

Level 4.

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来源期刊

Brazilian Journal of Otorhinolaryngology OTORHINOLARYNGOLOGY-

CiteScore

3.00

自引率

0.00%

发文量

205

审稿时长

4-8 weeks

期刊介绍： Brazilian Journal of Otorhinolaryngology publishes original contributions in otolaryngology and the associated areas (cranio-maxillo-facial surgery and phoniatrics). The aim of this journal is the national and international divulgation of the scientific production interesting to the otolaryngology, as well as the discussion, in editorials, of subjects of scientific, academic and professional relevance. The Brazilian Journal of Otorhinolaryngology is born from the Revista Brasileira de Otorrinolaringologia, of which it is the English version, created and indexed by MEDLINE in 2005. It is the official scientific publication of the Brazilian Association of Otolaryngology and Cervicofacial Surgery. Its abbreviated title is Braz J Otorhinolaryngol., which should be used in bibliographies, footnotes and bibliographical references and strips.