Complications and oncologic outcomes following elective neck dissection with salvage laryngectomy for the N0 neck

Surgical and pathological outcomes of elective neck dissection during salvage total laryngectomy

“…The impact of neck dissection on complications in the salvage laryngectomy setting has been previously investigated. Similar to our study, Freiser et al and Yao et al reported no correlation between neck dissections and fistula formation. Dagan et al and Bohannon et al reported a higher fistula rate when neck dissection was performed at the time of salvage laryngectomy.…”

Elective neck dissection during salvage laryngectomy: A systematic review and meta‐analysis

“…Five studies were included in the meta‐analysis for postoperative fistula formation, with a combined total of 408 patients (222 END, 186 observed) . There was no statistically significant difference in the risk of fistula formation between the two groups (95% CI: 0.61‐2.56) (Fig.…”

“…In our systematic review, END patients had a 23% risk of postoperative fistula and 41% risk of postoperative complication, compared with 18% and 28% for observed patients, respectively. However, on meta‐analysis of six studies and 494 patients, there was no significant difference in the risk of fistula formation (95% CI: 0.61‐2.56), but the statistical heterogeneity was too high to make a meaningful conclusion ( I 2 = 72.6%) . Without definite conclusions, the potential increase in morbidity with END is important to consider, especially in the setting of a lack of clear benefit to OS.…”

Elective neck dissection in patients with radio‐recurrent and radio‐residual squamous cell carcinoma of the larynx undergoing salvage total laryngectomy: Systematic review and meta‐analysis

“…Of the studies included in this review, the most commonly reported complication following salvage total laryngectomy for clinically node negative recurrences was pharyngocutaneous fistula formation. Previous chemoradiation was associated with increased wound complication on univariate analysis and found by other studies to be associated with increased fistula formation following salvage surgery . A total of 5 studies reported the number of pharyngocutaneous fistulas in their series, however only 2 of those studies compared fistula formation between END and no END groups; both series observed higher fistula rates in the END groups.…”

“…Previous chemoradiation was associated with increased wound complication on univariate analysis and found by other studies to be associated with increased fistula formation following salvage surgery . A total of 5 studies reported the number of pharyngocutaneous fistulas in their series, however only 2 of those studies compared fistula formation between END and no END groups; both series observed higher fistula rates in the END groups. The risk of fistula formation, although an important complication in this context and likely linked to surgical dissection of previously irradiated tissues, requires standardized reporting of rates to allow for further robust statistical testing of this association.…”