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Gomez-Hervás, Javier, Correa, Eduardo, Conti, Diego, Liva, Georgia, Merino-Galvez, Esteban. (1403). Risk Factors for Post Laryngectomy Pharyngocutaneous Fistula and Impact of Pharyngeal Suture Type on Fistula Characteristics. , 37(1), 11-17. doi: 10.22038/ijorl.2024.83054.3798
Javier Gomez-Hervás; Eduardo Correa; Diego Conti; Georgia Liva; Esteban Merino-Galvez. "Risk Factors for Post Laryngectomy Pharyngocutaneous Fistula and Impact of Pharyngeal Suture Type on Fistula Characteristics". , 37, 1, 1403, 11-17. doi: 10.22038/ijorl.2024.83054.3798
Gomez-Hervás, Javier, Correa, Eduardo, Conti, Diego, Liva, Georgia, Merino-Galvez, Esteban. (1403). 'Risk Factors for Post Laryngectomy Pharyngocutaneous Fistula and Impact of Pharyngeal Suture Type on Fistula Characteristics', , 37(1), pp. 11-17. doi: 10.22038/ijorl.2024.83054.3798
Gomez-Hervás, Javier, Correa, Eduardo, Conti, Diego, Liva, Georgia, Merino-Galvez, Esteban. Risk Factors for Post Laryngectomy Pharyngocutaneous Fistula and Impact of Pharyngeal Suture Type on Fistula Characteristics. , 1403; 37(1): 11-17. doi: 10.22038/ijorl.2024.83054.3798

Risk Factors for Post Laryngectomy Pharyngocutaneous Fistula and Impact of Pharyngeal Suture Type on Fistula Characteristics

Iranian Journal of Otorhinolaryngology
دوره 37، شماره 1، فروردین و اردیبهشت 2025، صفحه 11-17    اصل مقاله (375.89 K)
نوع مقاله: Original
شناسه دیجیتال (DOI): 10.22038/ijorl.2024.83054.3798
نویسندگان
Javier Gomez-Hervás* 1؛ Eduardo Correa2؛ Diego Conti3؛ Georgia Liva4؛ Esteban Merino-Galvez5
1Otolaryngology Department, Rafael Mendez University Hospital, Lorca, Spain.
2Otolaryngology Department, Hospital Comarcal de la Línea de La Concepción, Cádiz, Spain.
3Doctoral School UAM, Graduate Studies Center, Autonomous University of Madrid. Calle Francisco Tomás y Valiente, No. 2. Cantoblanco University City, 28049 Madrid, Spain. Allergy and Clinical Immunology Research Unit, Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium.
4Otorhinolaryngology Department, University Hospital of Heraklion, University of Crete, School of Medicine. Crete, Greece.
5Otolaryngology Department, San Antonio Catholic University of Murcia. Murcia, Spain.
چکیده
Introduction:
Pharyngocutaneous fistula (PCF) is the most common complication following total laryngectomy (TL). The factors contributing to its occurrence are still a matter of debate. The impact of suture type has been relatively underexplored. This study aimed to analyze the risk factors associated with PCF and understand how the type of suture influences PCF characteristics.
 
Materials and Methods:
An observational study encompassing all TL procedures was performed between 2005 and 2022 at a secondary care hospital. Sociodemographic and clinical variables widely studied in the literature to identify PCF risk factors were considered. Additionally, the characteristics of fistulas were examined to assess the influence of the suture type.
 
Results:
Seventy TL cases were included. The incidence of PCF was 56.0%. Identified risk factors for PCF included pharyngeal closure type (p=0.001) (RR=13.09), nutritional support type (p=0.001) (RR=13.54), the need for reintervention due to postoperative bleeding (p=0.001) (RR=1.13), and the need for blood transfusion after surgery (p=0.015) (RR=1.20). Regarding the suture type, Modified Connell Suture (MCS) was associated with a later onset of fistula (p=0.014), shorter hospital stay (p=0.001), and early initiation of oral feeding (p=0.009).
 
Conclusion:
PCF occurrence is associated with nasogastric tube use, Lambert closure, postoperative bleeding, and reintervention for bleeding after TL. Moreover, MCS sutures are linked to a shorter hospital stays and early initiation of oral feeding.
 
کلیدواژه‌ها
Cutaneous Fistula؛ Laryngectomy؛ Suture Techniques
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