Predictive Factors for the Postlaryngectomy Pharyngocutaneous Fistula Development: Systematic Review

Overview

Journal Braz J Otorhinolaryngol

Specialty Otorhinolaryngology

Date 2014 May 17

PMID 24830977

Citations 16

Authors

Suzana Boltes Cecatto

Matilde Monteiro Soares

Teresa Henriques

Eurico Monteiro

Carla Isabel Ferreira Pinto Moura

Affiliations

Soon will be listed here.

Abstract

Objective: Pharyngocutaneous fistula is considered one of the major complications in the postoperative period after total laryngectomy/pharyngolaryngectomy, leading to a severe adverse impact for the patient and society. This study aimed to identify all the described pharyngocutaneous fistula predictive factors and risk classifications.

Methods: Research was conducted to identify all the studies assessing predictive factors and risk classification for pharyngocutaneous fistula development published until April of 2012 (n = 846). The included studies were analyzed and data regarding their identification, methodological quality and results were recorded.

Results: A total of 39 studies were included. The variables consistently reported as associated with fistula development were nutritional deficiency, American Society of Anesthesiologists (ASA) classification, high consumption of alcohol, anemia and hypoalbuminemia, co-morbidities, advanced N stage, location and extent of primary tumor, pre-radiotherapy and pre-chemoradiotherapy treatment, emergency tracheotomy, surgical margin status, surgery's duration, surgeon's experience, local complications of the wound, performance of intraoperative blood transfusion and relationship between nasogastric tube and oral feeding.

Conclusion: Several risk factors were associated with pharyngocutaneous fistula formation in the included studies. However, there is still no consensus in the most pertinent selection. Only two classification systems were retrieved and they were not able to accurately predict pharyngocutaneous fistula.

Citing Articles

Temporal Variability in the Incidence and Risk Factors for Pharyngocutaneous Fistula Development after Total Laryngectomy.

Sifrer R, Dolenc M, Zore S, Fugina S, Jesenko L, Strojan P Cancers (Basel). 2024; 16(20).

PMID: 39456580 PMC: 11506730. DOI: 10.3390/cancers16203486.

Edge De-epithelialization for Reducing Pharyngocutaneous Fistula in Patch Free Flap Reconstructions for Salvage Total Laryngectomy Defects: A Case-Control Study.

Lin C, Lin P, Yang J, Kuo P, Tsai Y, Lin K Ann Surg Oncol. 2024; 31(13):9134-9140.

PMID: 39287904 DOI: 10.1245/s10434-024-16197-6.

Mapping the risk factors, pathogens, and antibiotic of pharyngocutaneous fistula in patients after neck open surgery.

Kong W, Chen M, Gu H, Han Y, Liu Y, Xia X Eur Arch Otorhinolaryngol. 2024; 281(8):4281-4289.

PMID: 38634896 DOI: 10.1007/s00405-024-08642-9.

Pharyngocutaneous Fistula Following Total Laryngectomy: a High-Volume Tertiary Centre Series.

Peneda J, Fernandes J, Monteiro E Indian J Surg Oncol. 2023; 14(3):742-748.

PMID: 37900634 PMC: 10611653. DOI: 10.1007/s13193-023-01765-1.

Risk Factors for Pharyngocutaneous Fistula Following Total Laryngectomy.

Peneda J, Fernandes J, Monteiro E Indian J Otolaryngol Head Neck Surg. 2023; 75(2):485-491.

PMID: 37274999 PMC: 10235409. DOI: 10.1007/s12070-022-03311-x.

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