“Fistula Zero” Project After Total Laryngectomy: The Candiolo Cancer Institute Experience

Crosetti, Erika; Arrigoni, Giulia; Sprio, Andrea Elio; Succo, Giovanni

doi:10.3389/fonc.2021.690703

Cited by 7 publications

(13 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Then, 191 full‐text manuscripts were assessed for eligibility. After applying the abovementioned inclusion and exclusion criteria, 23 studies 15–37 were included in the qualitative and quantitative synthesis. The reasons behind the exclusion of 168 studies are shown in Figure 1.…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Salivary bypass tube in total laryngectomy: Systematic review and meta‐analysis

et al. 2022

View full text Add to dashboard Cite

The aim of this study is to determine whether the preventive positioning of a salivary bypass tube (SBT) after total laryngectomy (TL) reduces the incidence of postoperative pharyngocutaneous fistula (PCF) and pharyngeal stenosis (PS). This study was conducted in conformity with the PRISMA statement. 1960 patients with a median age of 62.0 years were included. A SBT was placed in 980 (50%) patients (SBT group). The cumulative PCF incidence in the SBT group was 15.8% (95% CI: 9.3–23.6). The measured pooled OR comparing PCF incidence in patients with SBT compared to those without was 0.40 (95% CI: 0.24–0.65). The pooled PS incidence in the SBT group was 12.3% (95% CI: 5.4–21.6). The measured pooled OR comparing PS incidence in patients with SBT compared to those without was 0.43 (95% CI: 0.24–0.65). PCF and PS could be prevented by the intra‐operative placement of a SBT.

show abstract

Section: Resultsmentioning

confidence: 99%

“…Several reports have been published concerning the utility of SBT after TL, but its effectiveness and specific indications remain scarcely established 15–37 . The aim of this systematic review and meta‐analysis is to determine whether the preventive positioning of a SBT after TL may be associated to a reduced incidence of PCF and PS.…”

Section: Introductionmentioning

confidence: 99%

Salivary bypass tube in total laryngectomy: Systematic review and meta‐analysis

et al. 2022

View full text Add to dashboard Cite

show abstract

“…Notably, in the 2021 Italian endeavor ("Fistula zero" project after TL) which achieved excellent results, initiation of oral feeding was on the 10th postoperative day for TL only cases, and on the 13th for cases with TL and reconstruction. 20 Hence, it might not be in the best of the patient to restart oral feeding too early, especially after HPC surgeries. A study based on the Japanese national inpatient database reported 20 days as the median for oral feeding after pharyngolaryngectomy for HPC patients without PCF.…”

Section: Discussionmentioning

confidence: 99%

“…22 Based on the findings of this study, a swallow X-ray is ideal before initiation of oral intake. 20 In some institutions, NG-FT would be removed as soon as there is confirmation of no sign of PCF and oral intake is restarted. 22 In contrast, it is the practice of our institution and others that an oral liquid intake would be initiated first and gradually increased, while still using NG-FT to replenish the deficiency of oral intake.…”

Section: Discussionmentioning

confidence: 99%

Delayed oral feeding reduces pharyngocutaneous fistula formation after open surgical treatment of primary hypopharyngeal cancer: A case-control study

et al. 2022

View full text Add to dashboard Cite

Objectives Pharyngocutaneous fistula (PCF) formation following open surgical treatment of hypopharyngeal cancer (HPC) is a common and troublesome complication. To date, the postoperative protocol of restarting oral intake is not clear, and vast discrepancies exist in the literature and among institutions. This study aimed to explore the impact of a postoperative protocol of restarting oral intake on PCF formation after open surgical treatment of primary HPC, and its impact on overall survival (OS) and swallowing function based on the functional outcome swallowing scale (FOSS). Materials and Methods This was a prospective observational study of 42 patients who received open surgical treatment for primary HPC at Beijing Friendship Hospital between April 2019 and August 2021. This cohort included two groups: patients who restarted oral intake on the 10th postoperative day (Group 1), and those who started on the 20th (Group 2). The Chi-square test and Fisher’s exact chi-squared test were used for comparing qualitative data among the groups. Results Group 1 (n = 27) and Group 2 (n = 15) were comparable in clinical characteristics. PCF occurred in 7 (25.9%) patients in Group 1, while none occurred in Group 2 ( P = 0.038). The 2-year OS of all 42 patients was 75.6%; 65.8% and 93.3% for Groups 1 and 2, respectively ( P = 0.07). The swallowing function was satisfactory (FOSS Grades 0–III) for 19 (70.4%) patients in Group 1 and 15 (100%) patients in Group 2 ( P = 0.035). Laryngeal preservation was achieved in 25 (59.5%) patients, while decannulation was successful in 22 (88.0%) patients. Conclusions Delayed oral feeding significantly reduces PCF after open surgical treatment of primary HPC, and improves the swallowing function outcome without jeopardizing the OS.

show abstract

“…Another point to remember is that preventing PCF development remains of the uttermost importance: a recent interesting experience has presented a “fistula-zero project” after total laryngectomy which is mainly based on a watertight horizontal pharyngeal closure, the reinforcing flap for post-RT patients, and the use of salivary bypass tubes [ 21 ]. Besides prevention, a key aspect is to make an early diagnosis of fistula.…”

Section: Discussionmentioning

confidence: 99%

Non-Surgical Strategies for Assisting Closure of Pharyngocutaneous Fistula after Total Laryngectomy: A Systematic Review of the Literature

Locatello

Licci

Maggiore

et al. 2021

JCM

View full text Add to dashboard Cite

Background: Pharyngocutaneous fistula (PCF) is a frequent complication after total laryngectomy, with an incidence of up to 65%. Many conservative or invasive approaches are available and the choice among them is usually made on a case-by-case basis. The aim of the present review is to critically summarize the available evidence of the effectiveness of the non-surgical management of PCF. Methods: A systematic review and a meta-analysis of the literature were conducted, according to the PRISMA guidelines. Studies investigating botulinum toxin therapy, scopolamine transdermal patch, hyperbaric oxygen therapy (HBOT), and negative pressure wound therapy (NPWT) were assessed. Complete fistula closure after the initiation of non-surgical treatment was the main outcome. Results: After the application of selection criteria, a total of seven articles and 27 patients were included in the present review. All the eligible studies were descriptive case series, while only one article used a standard group as a comparison. The mean age was 63.3 and 14 patients (51.9%) had previously received RT. The reported comorbidities were diabetes, ischemic heart disease, hypertension, dyslipidemia, COPD, and atrial fibrillation. With a mean healing time of 25.0 days, the overall success rate was 92.6%. Conclusions: Non-surgical treatment of PCF is only based on the experience of small series. Although success rates seem promising, the absence of properly designed comparative studies does not allow us, at present, to identify ideal candidates for these non-invasive management strategies for PCF.

show abstract

“Fistula Zero” Project After Total Laryngectomy: The Candiolo Cancer Institute Experience

Cited by 7 publications

References 33 publications

Salivary bypass tube in total laryngectomy: Systematic review and meta‐analysis

Salivary bypass tube in total laryngectomy: Systematic review and meta‐analysis

Delayed oral feeding reduces pharyngocutaneous fistula formation after open surgical treatment of primary hypopharyngeal cancer: A case-control study

Non-Surgical Strategies for Assisting Closure of Pharyngocutaneous Fistula after Total Laryngectomy: A Systematic Review of the Literature

Contact Info

Product

Resources

About