Korean Journal of Head & Neck Oncology (대한두경부종양학회지)

The Korean Society for Head and Neck Oncology (대한두경부종양학회)
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Pharyngocutaneous Fistula Formation Rate after Total Laryngectomy, Related with Previous Radiotherapy and Extent of Surgery

방사선 치료 유무 및 수술 범위에 따른 후두전절제술 후 인두피부누공 발생률 분석

  • Kim, Seong Dong (Department of Otorhinolaryngology-Head & Neck Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine) ;
  • Yi, Yeo-Jeen (Department of Otorhinolaryngology-Head & Neck Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine) ;
  • Kim, Min-Soo (Department of Otorhinolaryngology-Head & Neck Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine) ;
  • Jeong, Woo-Jin (Department of Otorhinolaryngology-Head & Neck Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine) ;
  • Ahn, Soon-Hyun (Department of Otorhinolaryngology-Head & Neck Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine)
  • 김성동 (서울대학교 의과대학 분당서울대학교병원 이비인후과학교실) ;
  • 이여진 (서울대학교 의과대학 분당서울대학교병원 이비인후과학교실) ;
  • 김민수 (서울대학교 의과대학 분당서울대학교병원 이비인후과학교실) ;
  • 정우진 (서울대학교 의과대학 분당서울대학교병원 이비인후과학교실) ;
  • 안순현 (서울대학교 의과대학 분당서울대학교병원 이비인후과학교실)
  • Received : 2014.09.22
  • Accepted : 2014.10.02
  • Published : 2014.10.31
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Abstract

Background and Objectives : Pharyngocutaneous fistula is the most common complication after total laryngectomy. The objective of this study was to determine the incidence of pharyngocutaneous fistula after total laryngectomy in patients operated on in our department and to establish whether specific factors predispose to fistula formation. Materials and Methods : For 10 years(2003-2014), 49 cases of patients who were diagnosed with laryngeal cancer and underwent total laryngectomy in our department. Patients who underwent radiotherapy before the surgery was 24 cases(48.9%) of all total laryngectomy patients. And those who were needed flap reconstruction because of extensive tumor involvement to hypopharynx were also 24 cases(48.9%), whereas primary closure were performed in 25 cases(51%). Results : The postoperative pharyngocutaneous fistula was found in 12 of the 49 patients(24.5%). The radiotherapy before surgery was a statistically significant factor that increase the incidence of postoperative fistulas(p=0.037). Large extent of surgery including flap reconstruction was almost statistically significant factor of raising postoperative fistula rates(p=0.051). Conclusion : According to this study, the presence of postoperative fistula seems to be influenced by previous radiotherapy and the extent of surgery. These could be the risk factors of pharyngocutaneous fistula after total laryngectomy.

Keywords

References

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