Immediate complications of laryngectomy following high-dose preoperative radiotherapy

Robbins, Jeffrey P.; Marks, Richard D.; Fitz‐Hugh, G. Slaughter; Constable, William C.

doi:10.1002/1097-0142(197207)30:1<91::aid-cncr2820300115>3.0.co;2-6

Cited by 14 publications

(5 citation statements)

References 9 publications

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“…I n those patients in Group 2 of the present study this was performed according to the following guidelines : I A U-flap (Gluck-Saerensen) was usually employed (Figure 3). 2 Resection of skin for stoma through lower portion of the U-flap (Figure 3). 3 A wide field laryngectomy including hyoid bone and isthmus and lobe of the thyroid gland on the most affected side was always performed-especially in fixed cord cases.…”

Section: Discussionmentioning

confidence: 99%

Pharyngocutaneous fistulae following total laryngectomy

Lundgren

Olofsson

1979

Clin Otolaryngol

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Postoperative pharyngocutaneous fistula formation is a troublesome complication in head and neck surgery and occurred in 8 out of 53 patients following a total laryngectomy (15%). The incidence falls within the lower range of that reported in the literature (6-66%). Different factors which may influence the formation of fistulae were analysed. Factors which seem to increase fistula formation are previous full dose radiotherapy (Co60), residual carcinoma and surgical technique.

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Section: Discussionmentioning

confidence: 99%

Pharyngocutaneous fistulae following total laryngectomy

Lundgren

Olofsson

1979

Clin Otolaryngol

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“…(REPRINTED) ARCH OTOLARYNGOL HEAD NECK SURG/ VOL 132, JAN 2006 hemoglobin level and preoperative radiotherapy represent significant RRs in the pooled analysis, there is also significant heterogeneity of effects among studies (ie, several studies [1][2][3]6,[13][14][15]18,20,24 did not demonstrate an association between these factors and the risk of PCF formation). On the other hand, while increased risk of PCF was not shown to be associated with concurrent neck dissection and comorbid illness, the heterogeneity of effects among studies was significant.…”

Section: Commentmentioning

confidence: 99%

Complications in Head and Neck Surgery

Paydarfar

Birkmeyer²

2006

Arch Otolaryngol Head Neck Surg

301

103

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Objective: To summarize the potential risk factors for postlaryngectomy pharyngocutaneous fistula.Data Sources: Observational studies in the Englishlanguage literature about postlaryngectomy pharyngocutaneous fistula from January 1, 1970, to March 31, 2003 Studies were identified through a MEDLINE search with relevant key words; additional studies were identified through references. Study Selection:We included studies about the site of primary malignancy, type of procedure, and type of closure; studies had to have been based on individuallevel data, with a comparison group for each risk factor evaluated.Data Extraction: Data required to calculate the relative risk of fistula associated with commonly reported risk factors were abstracted from the studies, and a meta-analysis using a random-effects approach was performed to estimate a summary relative risk of fistula for each risk factor. The statistical signifi-cance of heterogeneity of effects among studies was assessed. Data Synthesis:Of 65 studies identified, 26 met the inclusion criteria. Significant risk factors identified in the pooled analysis included postoperative hemoglobin level less than 12.5 g/dL, prior tracheotomy, preoperative radiotherapy, and preoperative radiotherapy and concurrent neck dissection. The degree of heterogeneity of effects among studies was significant for postoperative hemoglobin level, preoperative radiotherapy, concurrent neck dissection, and comorbid illness. The severity of fistula was greater in patients with a history of radiotherapy.Conclusions: This meta-analysis identified several significant risk factors for postlaryngectomy pharyngocutaneous fistula. The clinical implications of these findings and the potential sources of heterogeneity of effects among studies are discussed.

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“…5 Traditionally, clinical studies have documented a 10% to 20% incidence of PCF after TLR. [6][7][8] These studies are mainly based on primary TLR. During the last decade, several studies have demonstrated improvement of outcome and a higher rate of larynx preservation after chemoradiation therapy over radiotherapy alone for advanced laryngeal cancer.…”

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confidence: 99%