Fistula and stenosis after 135 (pharyngo)laryngectomies.
BACKGROUND
Despite progress made with reconstruction, morbidity is still elevated after (pharyngo)laryngectomy. The present study was designed to determine the incidence and predisposing factors of the complications following (pharyngo)laryngectomy.


METHODS
Primary surgical treatment was delivered in 60 patients. Seventy-five patients underwent surgical salvage following radiotherapy. Different factors were evaluated as potentially predisposing to fistula formation.


RESULTS
Stenosis is rare: 5.1% in the present series. A pharyngocutaneous fistula developed in 48.8% of patients. After a multivariate analysis, the site of the tumour was defined as a significant risk factor for pharyngocutaneous fistula formation.


CONCLUSIONS
Despite progress made with reconstruction, morbidity is still elevated after major resection of the phary golarynx. Stenosis, a frequent complication when partial pharyngectomy is needed, is rare: 5.1% in the present series. Fistulas are relatively frequent but the majority resolved either with local irrigation or with subsequent flaps. The site of the tumour was a significant risk factor for pharyngocutaneous fistula formation, as defined by a multivariate analysis.
Dequanter
D
D
Department of Surgery, Institut Jules Bordet, Centre des Tumeurs de l'Université Libre de Bruxelles, Bruxelles, Belgium. didier.dequanter@chu-charleroi.be
Lothaire
Ph
P
Philippart
P
P
De Wan
J
J
Comblain
M
M
Deraemaecker
R
R
Andry
G
G
D002294:Carcinoma, Squamous Cell / Q000532:radiotherapy / Q000601:surgery; D003131:Combined Modality Therapy; D017577:Cutaneous Fistula / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007822:Laryngeal Neoplasms / Q000532:radiotherapy / Q000601:surgery; D007825:Laryngectomy / Q000009:adverse effects*; D007830:Larynx / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D010608:Pharyngeal Diseases / Q000453:epidemiology*; D010611:Pharyngectomy / Q000009:adverse effects*; D010614:Pharynx / Q000473:pathology*; D016156:Respiratory Tract Fistula / Q000453:epidemiology*