Open AccessIncidence and risk factors of pharyngocutaneus fistula formation after total laryngectomy. Review
Author(s) -
Cristina Isabel Sanz Sánchez,
Else Kraemer-Baeza,
María Dolores Aguilar Conde,
Eva Flores-Carmona,
Óscar Emilio Cazorla-Ramos
Publication year - 2020
Publication title -
revista orl
Language(s) - English
Resource type - Journals
ISSN - 2444-7986
DOI - 10.14201/orl.23703
Subject(s) - laryngectomy , medicine , incidence (geometry) , comorbidity , fistula , hypoalbuminemia , complication , surgery , tracheotomy , risk factor , radiation therapy , general surgery , larynx , physics , optics
and objective: The pharyngocutaneous fistula is a troublesome complication after total laryngectomy, increasing morbidity and mortality. We aimed to determine the incidence of pharyngocutaneus fistula after total laryngectomy and to define the possible predictors for pharyngocutaneus fistula formation. Method: We conducted a review of 31 articles with a total of 1100 patients, to evaluate the incidence of fistula in patients with total laryngectomy and risks factors involved. Results: The overall incidence of pharyngocutaneus fistula is 22,3%, and ranges from 3 to 65%. The review revealed that prior radiation treatment was the most common antecedent, following this associated comorbidity, hypoalbuminemia, anemia, and history of tracheotomy prior to laryngectomy. Discussion: Among the series studied, there is significant heterogeneity in the results, because although irradiated patients have a greater number of pharyngostomas, in some studies no relationship was found, which could explain the association with other risk factors. Conclusions: The incidence of pharyngocutaneus fistula is very variable and there are a large number of risk factors involved, the most frequent is radiotherapy associated or not with chemotherapy.