title: Effect of postoperative use of diclofenac on pharyngocutaneous fistula development after primary total laryngopharyngectomy: Results of a single-center retrospective study.
abstract: Primary total laryngopharyngectomy is the treatment of choice in many cases of locally advanced hypopharyngeal and laryngeal cancer. Development of pharyngocutaneous fistulae is the most common postoperative complication. A recent Danish study showed significantly increased rates of anastomosal leakage after colorectal resection in patients receiving diclofenac treatment.
  
  
  
  We retrospectively analyzed 67 patients after primary total laryngopharyngectomy to determine whether diclofenac increases the risk for development of pharyngocutaneous fistula analogously to leakage in the colorectal area.
  
  
  
  The fistula rate in the total study population (n = 67) was 19.4%. In the group receiving diclofenac postoperatively (n = 31), the fistula rate was 25.8%. In the patient group not receiving diclofenac (n = 36), the fistula rate was 13.9% (p = .219).
  
  
  
  Our results suggest that cyclooxygenase-2 (COX-2) selective nonsteroidal anti-inflammatory drugs (NSAIDs) should be administered with caution after laryngopharyngectomy. Additional studies on larger cohorts are required to further evaluate our findings. © 2015 Wiley Periodicals, Inc. Head Neck 38: E1515-E1520, 2016.
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Medical University of Vienna, Vienna, Austria.
authors.forename: Thomas
authors.initials: T
authors.lastname: Parzefall
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Medical University of Vienna, Vienna, Austria.
authors.forename: Axel
authors.initials: A
authors.lastname: Wolf
authors.affiliation: Department of Nuclear and Developmental Biology, Medical University of Vienna, Vienna, Austria.
authors.forename: Shelly
authors.initials: S
authors.lastname: Czeiger
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Medical University of Vienna, Vienna, Austria.
authors.forename: Klemens
authors.initials: K
authors.lastname: Frei
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Hospital of St. John of God, Vienna, Austria.
authors.forename: Michael
authors.initials: M
authors.lastname: Formanek
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Medical University of Vienna, Vienna, Austria.
authors.forename: Boban M
authors.initials: BM
authors.lastname: Erovic
mesh_terms: D017577:Cutaneous Fistula / Q000188:drug therapy / Q000517:prevention & control*; D004008:Diclofenac / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007822:Laryngeal Neoplasms / Q000601:surgery; D007825:Laryngectomy / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D010610:Pharyngeal Neoplasms / Q000601:surgery; D010611:Pharyngectomy / Q000009:adverse effects*; D011182:Postoperative Care; D011183:Postoperative Complications; D012189:Retrospective Studies
chemical_list: D004008:Diclofenac
keywords: diclofenac; laryngopharyngectomy; nonsteroidal anti-inflammatory drug (NSAID); pharyngocutaneous fistula; primary laryngectomy