[Study of pharyngo-cutaneous fistula after total laryngectomy].
OBJECTIVE
To explore the factors which lead to pharyngo-cutaneous fistula after total laryngectomy.


METHODS
A retrospective study of 125 patients who underwent total laryngectomy during a 16-year period was carried out.


RESULTS
The rate of post-laryngectomy pharyngo-cutaneous fistula is 16.0% (20/125), it appears reduced tendency. With single-factor analysis, the factors effect on the rate of post-laryngectomy pharyngo-cutaneous fistula include clinical tumor stage, tumor types, pre-operative radiotherapy dose, intraoperative blood transfusion, operative duration. With all variable logistic model analysis, the factors effect on the rate of pharyngo-cutaneous fistula are clinical tumor stage and pre-operative radiotherapy dose, but pre-operative radiotherapy is very possible to be a risk factor (P = 0.0566). With logistic model stepwise regression analysis, the factors effect on the rate of pharyngo-cutaneous fistula are clinical tumor stage and operative duration.


CONCLUSIONS
Pharyngo-cutaneous fistula appears easily in patients with T3, T4 tumor, and have pre-operative radiotherapy, especially have large dose preradiotherapy. For these high risk patients, the duration of operation should be as short as possible to reduce the rate of post-laryngectomy pharyngo-cutaneous fistula.
Lü
W
W
Department of Otolaryngology, Peking Union Hospital, Chinese Acadamy of Medical Sciences, Peking Union Medical College, Beijing 100730.
Zhang
B
B
Ni
D
D
Zhang
L
L
D000328:Adult; D000368:Aged; D017577:Cutaneous Fistula / Q000209:etiology*; D005260:Female; D005402:Fistula / Q000209:etiology*; D006801:Humans; D007822:Laryngeal Neoplasms / Q000601:surgery; D007825:Laryngectomy / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D010608:Pharyngeal Diseases / Q000209:etiology*; D012189:Retrospective Studies; D012307:Risk Factors