Iranian Journal of Otorhinolaryngology

Iranian Journal of Otorhinolaryngology

Evaluation of the Incidence of Pharyngocutaneous Fistula after Total Laryngectomy

Document Type : Original

Authors
Maziar Motiee Langroudi 1
Mehrdad Jafari 1
Roxana Safari 2
Mehraveh Sadeghi Ivraghi 3
Alireza Mazarei 4
1 Department of Otorhinolaryngology, Tehran University of Medical Sciences, Tehran, Iran.
2 Department of Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
3 Department of Medicine, School of Medicine, Qazvin University of Medical Sciences, Qazvin, Iran.
4 Otorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
10.22038/ijorl.2023.69853.3370
Abstract
Introduction:
Laryngeal squamous cell carcinoma is one of the most critical head and neck cancers. Total laryngectomy is one of the main options for treating laryngeal squamous cell carcinoma responsible for forming pharyngocutaneous fistula (PCF), which increases morbidity and mortality. This study aimed to determine PCF incidence and identify the factors associated with this complication.
Materials and Methods:
In a retrospective cohort study, 85 patients who underwent total laryngectomy at Imam Khomeini Hospital (Tehran, Iran) from 2011 to 2019 were selected as the study population. The presence/absence of PCF, weight, anemia status (Hb <12.5 g/dl), renal dysfunction status (GFR <90 mL/min/1.73m2), malnutrition status (Albumin <3.5 g/dl), and marginal involvement status was extracted from postoperative medical records. The data were analyzed using SPSS ver. 26.0. 
Results:
The overall incidence of PCF was 11.8%. The mean ±SD of the duration of hospitalization in patients with PCF was 32.40 ±14.75 days, and in patients without PCF was 16.89 ±7.05 days (P = 0.009). The mean ±SD of time to develop a fistula was 7.4 ±3.74 days. 
Conclusions:
The statuses of anemia, malnutrition, renal dysfunction, surgical margin, history of radiotherapy, pharynx closure, gender, and age were unrelated to the incidence of PCF. Further studies with a larger sample size are recommended.
Keywords
Pharyngocutaneous Fistula
Laryngectomy
Incidence
Risk Factors
Subjects
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Iranian Journal of Otorhinolaryngology
Volume 35, Issue 3
May and June 2023
Pages 141-146