title: Efficacy of pectoralis major muscle flap for pharyngocutaneous fistula prevention in salvage total laryngectomy: A systematic review.
abstract: The role of pectoralis major muscle flap (PMMF) in reducing the rate of pharyngocutaneous fistula after salvage total laryngectomy has not been clearly established. The purpose of this study was to evaluate the impact of PMMF in reducing pharyngocutaneous fistula rates after total laryngectomy.
  
  
  
  The analyzed intervention was the use of a PMMF after total laryngectomy.
  
  
  
  Pharyngocutaneous fistula occurred in 230 cases (global incidence, 30.9%). In the group of patients who underwent PMMFs, there were 49 cases of pharyngocutaneous fistula, compared with 181 cases in the control group. There was a 22% decreased risk of pharyngocutaneous fistula incidence in the PMMF group (p < .001). Patients who underwent a PMMF had lower risk of pharyngocutaneous fistula compared with the control group (p = .008). There were no changes when only patients who underwent total laryngectomy (p < .001) and those who underwent total pharyngolaryngectomy (p = .007) were separately assessed.
  
  
  
  Prophylactic use of PMMF decreases the incidence of pharyngocutaneous fistula after salvage total laryngectomy. © 2015 Wiley Periodicals, Inc. Head Neck 38: E2317-E2321, 2016.
authors.affiliation: Department of Head and Neck Surgery, Hospital das Clínicas, University of São Paulo School of Medicine, São Paulo, Brazil.
authors.forename: André Vicente
authors.initials: AV
authors.lastname: Guimarães
authors.affiliation: Department of Head and Neck Surgery, Hospital das Clínicas, University of São Paulo School of Medicine, São Paulo, Brazil.
authors.forename: Felipe Toyama
authors.initials: FT
authors.lastname: Aires
authors.affiliation: Department of Head and Neck Surgery, Hospital das Clínicas, University of São Paulo School of Medicine, São Paulo, Brazil.
authors.forename: Rogério Aparecido
authors.initials: RA
authors.lastname: Dedivitis
authors.affiliation: Department of Head and Neck Surgery, Cancer Institute of São Paulo ICESP, São Paulo, Brazil.
authors.forename: Marco Aurélio Vamondes
authors.initials: MA
authors.lastname: Kulcsar
authors.affiliation: Department of Head and Neck Surgery, Cancer Institute of São Paulo ICESP, São Paulo, Brazil.
authors.forename: Daniel Marin
authors.initials: DM
authors.lastname: Ramos
authors.affiliation: Department of Head and Neck Surgery, Hospital das Clínicas, University of São Paulo School of Medicine, São Paulo, Brazil.
authors.forename: Claudio Roberto
authors.initials: CR
authors.lastname: Cernea
authors.affiliation: Department of Head and Neck Surgery, Hospital das Clínicas, University of São Paulo School of Medicine, São Paulo, Brazil.
authors.forename: Lenine Garcia
authors.initials: LG
authors.lastname: Brandão
mesh_terms: D017577:Cutaneous Fistula / Q000517:prevention & control*; D006801:Humans; D007822:Laryngeal Neoplasms / Q000601:surgery*; D007825:Laryngectomy; D010369:Pectoralis Muscles / Q000637:transplantation*; D010608:Pharyngeal Diseases / Q000517:prevention & control*; D012189:Retrospective Studies; D016879:Salvage Therapy; D013524:Surgical Flaps / Q000637:transplantation*
keywords: carcinoma; cutaneous fistula; laryngeal neoplasms; laryngectomy; meta-analysis; pectoralis major flap; postoperative complications; squamous cell