Pharyngocutaneous
fistula (PCF) is the most common surgical complication after total
laryngectomy. Controversy still remains regarding the multiple risk factors
implicated.
Dedivitiset al. surveyed the literature up to December 2013. The risk factors analyzed
were age, sex, smoking habit, alcohol use, comorbidity, preoperative hemoglobin
level, blood transfusion, preoperative tracheotomy, previous radiotherapy and
chemoradiotherapy, primary tumor site, T classification, cartilage invasion,
tumor grade, surgical margins, suture material, second layer of suture,
reconstruction, tracheoesophageal prosthesis, and neck dissection. Of the 311
studies that were evaluated 63 met the inclusion criteria.
The
author found that the risk factors for PCF were: chronic obstructive pulmonary
disease (COPD), previous hemoglobin < 12.5 g/dL, blood transfusion, previous
radio or chemotherapy, advanced primary tumor, suprglotic subsite,
hypopharyngeal tumor site, positive surgical margins, and the performance of
neck dissection.
Liang et al. who performed meta-analysis on on 16 studies found that tumor ssubsite,
T stage, previous radiotherapy, postoperative hemoglobin < 12.5 g/dL, and
surgical margins were the risk factors associated with the development of PCF.
Recognition
of these factors can assist clinicians in expecting and treating PCF.
MRI of a pharyngocutaneous fistula after laryngopharyngectomy, and radial forearm free flap
