title: Pharyngocutaneous fistula and delay in free oral feeding after pharyngolaryngectomy for hypopharyngeal cancer.
abstract: Risk factors for pharyngocutaneous fistula and associated delay in free oral feeding after pharyngolaryngectomy for patients with hypopharyngeal cancer remain uncertain.
  
  
  
  We used a Japanese national inpatient database to perform a retrospective cohort study between 2007 and 2013. We performed multivariable logistic regression analysis to identify patient characteristics associated with pharyngocutaneous fistula formation, and Cox regression analysis to evaluate factors affecting the interval from pharyngolaryngectomy to free oral feeding.
  
  
  
  Among 549 eligible patients, 33 had developed pharyngocutaneous fistula, 19 of whom required surgical closure. Preoperative radiotherapy significantly increased risk of pharyngocutaneous fistula (odds ratio [OR] = 3.17; 95% confidence interval [CI] = 1.10-9.12; p = .033). Pharyngocutaneous fistula significantly prolonged the interval to oral feeding (median days, 67 vs 20 in those with and without pharyngocutaneous fistula, respectively; hazard ratio [HR], = 0.26; 95% CI = 0.15-0.44; p < .001).
  
  
  
  Preoperative radiotherapy was associated with increased occurrence of pharyngocutaneous fistula and subsequent delay in free oral feeding. © 2015 Wiley Periodicals, Inc. Head Neck 38: E-E, 2016.
authors.affiliation: Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan.|Department of Otolaryngology and Head and Neck Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: Sayaka
authors.initials: S
authors.lastname: Suzuki
authors.affiliation: Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan.
authors.forename: Hideo
authors.initials: H
authors.lastname: Yasunaga
authors.affiliation: Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Matsui
authors.affiliation: Department of Clinical Data Management and Research, Clinical Research Center, National Hospital Organization Headquarters, Tokyo, Japan.
authors.forename: Hiromasa
authors.initials: H
authors.lastname: Horiguchi
authors.affiliation: Department of Health Policy and Informatics, Tokyo Medical and Dental University Graduate School of Medicine, Tokyo, Japan.
authors.forename: Kiyohide
authors.initials: K
authors.lastname: Fushimi
authors.affiliation: Department of Otolaryngology and Head and Neck Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Yamasoba
mesh_terms: D000368:Aged; D017577:Cutaneous Fistula / Q000473:pathology*; D004435:Eating; D005260:Female; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000601:surgery*; D007825:Laryngectomy / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D010608:Pharyngeal Diseases / Q000473:pathology*; D010611:Pharyngectomy / Q000009:adverse effects*; D011183:Postoperative Complications; D011300:Preoperative Care; D011878:Radiotherapy / Q000009:adverse effects; D012189:Retrospective Studies
keywords: free oral feeding; hypopharyngeal cancer; pharyngocutaneous fistula; pharyngolaryngectomy