[Pharyngocutaneous fistula after total laryngectomy: incidence and analysis of risk factors].
OBJECTIVE
We evaluated the incidence and predisposing risk factors of pharyngocutaneous fistulas that develop after total laryngectomy.


METHODS
The records of 210 patients (19 females, 191 males; mean age 60+/-9 years; range 39 to 77 years) who underwent total laryngectomy were retrospectively reviewed. Thirteen predisposing risk factors were evaluated (age, sex, pre-and postoperative anemia and hypoalbuminemia, diabetes mellitus, coronary artery disease, chronic obstructive pulmonary disease, hypertension, preoperative tracheotomy, tumor stage and localization).


RESULTS
Pharyngocutaneous fistulas were found in 41 patients (19.5%). The mean duration for fistula formation was 7.7 days (range 2 to 16 days). Coronary artery disease (p=0.00), postoperative hemoglobin (p=0.000) and albumin (p<0.005) levels lower than 10.7+/-1.2 g/dl and 3.0+/-0.5 g/dl, respectively, were found to be significant risk factors for fistula formation.


CONCLUSIONS
Fistula formation is the most frequent complication in laryngectomy patients. To prevent fistula formation, special attention should be paid to surgical technique and postoperative care especially in patients who have coronary artery disease, anemia, and hypoalbuminemia.
Güçlü
Elif
E
Department of Otolaryngology, Izmir Training and Research Hospital, Izmir, Turkey.
Pinar
Ercan
E
Oncel
Semih
S
Calli
Cağlar
C
D000328:Adult; D000368:Aged; D017577:Cutaneous Fistula / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology; D005260:Female; D006801:Humans; D015994:Incidence; D007825:Laryngectomy / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D010608:Pharyngeal Diseases / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology; D011183:Postoperative Complications; D012307:Risk Factors; D014421:Turkey / Q000453:epidemiology