scholarly journals Inflammatory indices predict pharyngocutaneous fistula formation after total laryngectomy

2021 ◽  
Vol 17 (2) ◽  
pp. 98-103
Author(s):  
Levent Yucel ◽  
◽  
Sibel Yildirim ◽  
Hasay Guliyev ◽  
Hazan Basak ◽  
...  
Keyword(s):  
Total Laryngectomy ◽  
Fistula Formation ◽  
Pharyngocutaneous Fistula

The techniques of nonmuscular closure of hypopharyngeal defect following total laryngectomy: the assessment of complication and pharyngoesophageal segment

1997 ◽  
Vol 111 (11) ◽  
pp. 1060-1063 ◽  
Author(s):  
Ching-Ping Wang ◽  
Tzu-Chan Tseng ◽  
Rheun-Chuan Lee ◽  
Shyue-Yih Chang
Keyword(s):  
Total Laryngectomy ◽  
Fistula Formation ◽  
Voice Rehabilitation ◽  
Pharyngocutaneous Fistula ◽  
Swallowing Function ◽  
Pharyngeal Muscle ◽  
Constrictor Muscle ◽  
Pharyngoesophageal Segment ◽  
Pharyngeal Muscles ◽  
Closure Group

AbstractThe usual method of reconstructing a hypopharyngeal defect during total laryngectomy includes pharyngeal muscle layer closure, which may result in high pharyngoesophageal pressure. We hypothesize that nonclosure of the pharyngeal muscle can reduce the pressure of the pharyngoesophageal segment which can reduce the chances of the formation of pharyngocutaneous fistulae. A technique of nonmuscular closure of a hypopharyngeal defect is presented. The differences in the rate of fistula formation and swallowing function between patients with usual and nonmuscular closure were also studied. Sixty consecutive laryngectomees were enrolled in this study. Thirty patients received usual closure after total laryngectomy, whereas the other 30 patients underwent non closure of their pharyngeal muscles. One patient (3.3 per cent) in the nonmuscular closure group and three patients (10 per cent) in the usual closure group developed a pharyngocutaneous fistula. The pharyngoesophageal pressures of the nonmuscular closure group were significantly lower than those of the usual closure group. We conclude that the technique of nonclosure of the pharyngeal constrictor muscle after total laryngectomy is relatively more simple and is not associated with a higher rate of fistula formation. Furthermore, nonclosure of the pharyngeal constrictor muscle is preferable to muscular closure because it reduces the spasm of the pharyngoesophageal segment which limits voice rehabilitation.

Pharyngocutaneous fistula and total laryngectomy: possible predisposing factors, with emphasis on pharyngeal myotomy

2000 ◽  
Vol 114 (10) ◽  
pp. 768-771 ◽  
Author(s):  
A. Ö. İkiz ◽  
M. Uça ◽  
E. A. Güneri ◽  
T. K. Erdağ ◽  
S. Sütay
Keyword(s):  
Neck Dissection ◽  
Nasogastric Tube ◽  
Total Laryngectomy ◽  
Positive Association ◽  
Fistula Formation ◽  
Pharyngocutaneous Fistula ◽  
Technical Error ◽  
Significant Positive Association ◽  
Positive Surgical Margins ◽  
Tumour Differentiation

Ninety-two total laryngectomy cases were investigated with reference to post-laryngectomy fistula formation. Fistula was observed in eight cases (8.69 per cent). There were no statistically significant differences between the fistula group and the non-fistula group with regard to pre-operative tracheotomy, tumour differentiation, positive surgical margins, concurrent neck dissection, previous radiotherapy, T stage of the tumour, presence of extended hypopharyngeal mucosal excision, and placement of nasogastric tube. The only statistically significant positive association was found with primary pharyngeal myotomy. Myotomy was performed in six of the fistula patients and in two cases a technical error was observed. In these cases myotomy was performed adjacent to the edge of hypopharyngeal mucosa resulting in a weakened area of pharyngeal closure, possibly contributing to the fistula. This should be kept in mind and avoided at all costs during the performance of myotomy. Since it was not possible to find out any specific causal relationship with myotomy in four other cases, further studies are needed to establish the association of myotomy with pharyngocutaneous fistula.

Post-laryngectomy pharyngocutaneous fistula – a still unresolved problem

1995 ◽  
Vol 109 (3) ◽  
pp. 221-224 ◽  
Author(s):  
Milo Fradi ◽  
Ludwig Podoshin ◽  
Jaacov Ben David
Keyword(s):  
Nasogastric Tube ◽  
Late Stage ◽  
Total Laryngectomy ◽  
Surgical Repair ◽  
Spontaneous Closure ◽  
Fistula Formation ◽  
Pharyngocutaneous Fistula ◽  
Infection Age ◽  
Neck Irradiation ◽  
Specific Factors

AbstractFifty-six total laryngectomy cases are presented with special reference to post-operative fistula formation. All these patients were operated upon at the Department of Otorhinolaryngology at the Bnai Zion Medical Centre by one surgeon over a 16-year period, from 1976–1992. The incidence of fistula was 12.5 percent. This paper could not verify reports that any specific factors were significantly related to fistula formation, although there was a preponderance of fistulas in patients presenting with late stage tumours. No relationship was found with rate of infection, age, or between previous neck irradiation (ranging from 5500 to 7000 cGy) and fistula formation in the patient population.If a fistula occurs, the administration of oral solid food keeping the nasogastric tube in place for administration of fluids may lead to spontaneous closure of the fistula, with no need for secondary surgical repair.

scholarly journals Early versus delayed oral feeding post total laryngectomy and relation to trachea-oesophageal fistula formation

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
H A Elibiary ◽  
T A Aboelezz ◽  
O M Mady ◽  
A O T Keshk
Keyword(s):  
Hospital Stay ◽  
Total Laryngectomy ◽  
Malignant Tumors ◽  
Group Versus ◽  
Oral Feeding ◽  
Fistula Formation ◽  
Voice Rehabilitation ◽  
Pharyngocutaneous Fistula ◽  
Early Oral Feeding ◽  
Feeding Group

Abstract Background total laryngectomy is the most common procedure in treatment of advanced laryngeal malignant tumors. Total laryngectomy although an important and reliable method of management, still carries a lot of short term and long term complications. One of the common complications is the pharyngocutaneous fistula. Being a major risk factor of longer hospital stay, morbidity and wound infection. Pharyngocutaneous fistula is studied carefully concerning causes, risk factors and management. Oral feeding and voice rehabilitation are two valuable outcomes for the patient. Both could be disturbed by occurrence of pharyngocutaneous fistula. Oral feeding usually starts by the seventh to tenth day postoperative to allow adequate time for pharyngeal closure as believed by many surgeons for decades. Recent studies including our study discuss the possibility of early oral feeding versus conventional delayed feeding and its advantages regarding hospital stay and incidence of fistula. Aim The aim of this study is to points out the rate of pharyngocutaneous fistulae incidence after total laryngectomy in two different groups of patients depending on timing of post-operative oral feeding. Oral feeding usually starts after 7-10 days of surgery to allow for complete healing and closure of pharyngeal repair. Methodology A meta-analysis study is done to assess the feasibility and the possibility of early oral feeding after total laryngectomy versus delayed oral feeding. The outcome is the occurrence of pharyngocutaneous fistula in each group. Results In all included studies the incidence of pharyngocutaneous fistula was 168/1374 (12.23%) in early feeding group versus 69/570 (12.11%) in the delayed feeding group. The statistical difference was insignificant P > 0.05 Conclusion Early oral feeding after total laryngectomy during the first 72 hours post-operative is a safe clinical practice and results in shorter hospital stay.

Incidence and predisposing factors of pharyngocutaneous fistula formation after total laryngectomy. Is there a relationship with tumor recurrence?

2004 ◽  
Vol 261 (2) ◽  
pp. 61-67 ◽  
Author(s):  
Konstantinos D. Markou ◽  
Konstantinos C. Vlachtsis ◽  
Angelos C. Nikolaou ◽  
Dimitrios G. Petridis ◽  
Athanasios I. Kouloulas ◽  
...  
Keyword(s):  
Total Laryngectomy ◽  
Tumor Recurrence ◽  
Predisposing Factors ◽  
Fistula Formation ◽  
Pharyngocutaneous Fistula

Postlaryngectomy Pharyngocutaneous Fistula: Incidence, Predisposing Factors, and Therapy

2005 ◽  
Vol 133 (5) ◽  
pp. 689-694 ◽  
Author(s):  
Jacopo Galli ◽  
Eugenio De Corso ◽  
Mariangela Volante ◽  
Giovanni Almadori ◽  
Gaetano Paludetti
Keyword(s):  
Risk Factor ◽  
Total Laryngectomy ◽  
Radical Neck Dissection ◽  
Predisposing Factors ◽  
Spontaneous Closure ◽  
Pharyngocutaneous Fistula ◽  
Systemic Diseases ◽  
Surgical Closure ◽  
Number Of Factors ◽  
Wait And See

OBJECTIVE: The pharyngocutaneous fistula (PCF) is a serious complication after total laryngectomy, and its etiology is not well understood yet. The aim of our study was to evaluate predisposing factors, incidence, and management of this complication. STUDY DESIGN AND SETTING: This was a retrospective study of 268 patients who underwent total laryngectomy in our clinic (January 1990-December 2001). A number of factors potentially predisposing to PCF formation were evaluated. RESULTS: A PCF was observed in 16% of patients. Systemic diseases, previous radiotherapy, supraglottic origin of tumor, and concurrent radical neck dissection were significantly associated with PCF. Spontaneous closure was noted in 28 patients, whereas a surgical closure was necessary in 15 patients. CONCLUSIONS: In presence of a specific risk factor, PCF can be expected; nevertheless, its prevention remains very difficult. Moreover, given the high percentage of spontaneous closure, we suggest the “wait and see” approach for 28 days before proceeding with a surgical approach.

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