A review of pharyngeal mucosal closure technique in total laryngectomy

Abstract

<p class="abstract"><strong>Background:</strong> The purpose of this retrospective analysis was to review our single institute based experience with the pharyngocutaneous fistula following total laryngectomy and to determine the impact of pharyngeal closure technique in the development of PCF in our patients.</p><p class="abstract"><strong>Methods:</strong> The medical records of the patients, who underwent total laryngectomy for squamous cell carcinoma of the larynx and hypopharynx in Government Royapettah Hospital, center for oncology between January 2010 and December 2017, were retrospectively reviewed. </p><p class="abstract"><strong>Results:</strong> 26 patients were included in the study of which 25 were male and 1 was female. Mean age of the patients were 58 years. Horizontal closure was done in 9 patients (35%) and T closure was done in 17 patients (65%). PCF was observed in 1 of 9 patients in horizontal closure. Remaining 17 patients underwent T closure of whom 8 patients developed PCF (p=0.06). Eight out of 18 patients (44%) developed PCF after salvage surgery after radiotherapy failure, Remaining 8 patients underwent primary laryngectomy for advanced stage cancers with cartilage involvement, of whom 1 patient developed PCF (12.5%) (p=0.11). In salvage laryngectomy (n=18), 1 of 6 cases developed PCF in horizontal closure and 7 of 12 cases in T closure technique (p=0.09).</p><p class="abstract"><strong>Conclusions:</strong> The incidence of fistula in our study was 34%. Horizontal closure was associated with decreased incidence of PCF when compared to ‘T’ closure of the defect. Prior radiotherapy had increased incidence of PCF.</p>

Pharyngeal Reconstruction Methods to Reduce the Risk of Pharyngocutaneous Fistula After Primary Total Laryngectomy: A Scoping Review

“…Twelve studies were identified comparing the shape of manual suture, which included primary [ 25 , 31 – 33 ] and mixed primary/salvage TL [ 34 – 41 ] (Table 2 ). Bril et al [ 42 ] did not report specific rates of PCF and the study was thus excluded.…”

Đánh Giá Kết Quả Phương Pháp Đóng Họng Kiểu T Bằng Mũi Khâu Gambee Trong Phẫu Thuật Cắt Thanh Quản Toàn Phần

“…So với các nghiên cứu đã được thực hiện tại Việt Nam, tuổi trung bình trong nghiên cứu của cúng tôi không có sự khác biệt [9], [11]. Tuổi trung bình trong nghiên cứu của chúng tôi cũng tương đương với một số nghiên cứu nước ngoài [4], [8].…”

“…Điều này phù hợp với y văn và các nghiên cứu trong và ngoài nước là nam bị UTTQ nhiều hơn nữ. Kết quả nghiên cứu của chúng tôi không có sự khác biệt so với các kết quả nghiên cứu trong nước [9] và ngoài nước [4], [8]. Nhiều tác cho rằng nữ giới ít bị UTTQ là do ít tiếp xúc với các yếu tố có liên quan đến gây bệnh hơn so với nam giới.…”