[Post-laryngectomy pharyngocutaneous fistula--a continuing clinical problem].
BACKGROUND
Pharyngocutaneous fistula following laryngectomy is a serious complication, and its incidence varies from 4% to 65%. The study's objective was to determine the incidence of post laryngectomy fistulas in patients operated in our department to establish whether specific factors predispose to fistula formation.


METHODS
A retrospective study was performed in 573 patients who underwent laryngectomy.


RESULTS
Between 1989 and 1999, 835 cases of laryngeal carcinoma were diagnosed, 690 were treated surgically, 573 of them underwent laryngectomy in our department. Of these patients, 545 (95,1%) had total laryngectomy, while 28 (4,9%) partial laryngectomy. In 538 cases the laryngectomy was combined with radical or functional neck dissection. The presence of early postoperative fistula was established in 65 of the 573 patients (11,3%). Our study could not verify reports that any specific factors were significantly related to fistula formation, the only factors that did show statistical significance were the preoperative patient's general health status and the kind of postoperative antibiotic therapy.


CONCLUSIONS
On the base of literature review, the authors compare results obtained in the last decade of the 20 century with results obtained earlier. Although the incidence of post-laryngectomy pharyngocutaneous fistulas decreased in comparison with the fistula rate observed earlier, the problem is still unresolved, and the fistulae remain a serious complication of larynx oncology surgery.
Betlejewski
Stanisław
S
Katedra Zdrowia Publicznego Collegium Medicum im L. Rydygiera w Bydgoszczy.
Szymańska-Skrzypek
Anna
A
D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology / Q000601:surgery*; D017577:Cutaneous Fistula / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006801:Humans; D015994:Incidence; D007822:Laryngeal Neoplasms / Q000453:epidemiology / Q000601:surgery*; D007825:Laryngectomy / Q000009:adverse effects / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology* / Q000601:surgery; D009367:Neoplasm Staging; D010406:Penicillins / Q000009:adverse effects; D010608:Pharyngeal Diseases / Q000453:epidemiology*; D011044:Poland / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000209:etiology; D016896:Treatment Outcome
D010406:Penicillins