title: Pharyngocutaneous fistula complicating laryngectomy: can metronidazole help?
abstract: OBJECTIVE
  To evaluate the use of metronidazole as a prophylactic agent against pharyngocutaneous fistula (PCF) formation.
  
  
  METHODS
  Seventy patients who underwent total laryngectomy between 2000 and 2008 in our department were divided into two groups. The first group (M+ group) was placed on a 10-day metronidazole regimen (2 days prior to surgery and 7 days following). The second group (M- group) received only regular preoperative chemoprophylaxis.
  
  
  RESULTS
  In total, 17 (24.3%) incidents of PCF were reported, 3 of which were in the M+ group, with the remainder in the M- group. A statistically significant reduction in the PCF rate was noted in favor of metronidazole in the overall population (p = 0.005), as well as in the patient group that had received radiotherapy prior to surgery (p = 0.03).
  
  
  CONCLUSIONS
  Metronidazole administered for a total of 10 days pre- and postoperatively seems to lower the incidence rate of PCF formation.
authors.affiliation: ENT Department, University Hospital of Patras, Patras, Greece. ent.upatras@gmail.com
authors.forename: Theodoros
authors.initials: T
authors.lastname: Stathas
authors.forename: Antonios
authors.initials: A
authors.lastname: Mallis
authors.forename: Nicholas S
authors.initials: NS
authors.lastname: Mastronikolis
authors.forename: Stefanos S
authors.initials: SS
authors.lastname: Naxakis
authors.forename: Konstantina
authors.initials: K
authors.lastname: Dimaka
authors.forename: Theodora
authors.initials: T
authors.lastname: Panogeorgou
authors.forename: Stavros
authors.initials: S
authors.lastname: Stavrou
authors.forename: Vasilios
authors.initials: V
authors.lastname: Margaritis
authors.forename: Christos
authors.initials: C
authors.lastname: Kourousis
authors.forename: Theodoros A
authors.initials: TA
authors.lastname: Papadas
mesh_terms: D000368:Aged; D000890:Anti-Infective Agents / Q000008:administration & dosage; D003131:Combined Modality Therapy / Q000379:methods; D017577:Cutaneous Fistula / Q000453:epidemiology / Q000517:prevention & control*; D005260:Female; D006801:Humans; D015994:Incidence; D007822:Laryngeal Neoplasms / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*; D007825:Laryngectomy / Q000009:adverse effects*; D008297:Male; D008795:Metronidazole / Q000008:administration & dosage*; D008875:Middle Aged; D009367:Neoplasm Staging; D010608:Pharyngeal Diseases / Q000453:epidemiology / Q000517:prevention & control*; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control*; D012307:Risk Factors
chemical_list: D000890:Anti-Infective Agents; D008795:Metronidazole