Pharyngocutaneous Fistula after Total Laryngectomy: Incidence, Cause, and Treatment

Papazoglou, George; Terzakis, George; Doundoulakis, George; Dokianakis, G.

doi:10.1177/000348949410301010

Cited by 93 publications

(91 citation statements)

References 16 publications

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“…Several reports represent evidences incriminating some of these factors, while others do not arrive at similar conclusions (4,5,6,11,13,14,19).…”

Section: Introductionmentioning

confidence: 99%

“…Despite these improvements, many patients still experience recurrent disease requiring salvage surgery, most frequently as a total laryngectomy. It has been reported that occurrence of post-operative wound complication is affected by the treatment prior to salvage surgery, mainly irradiation (4,5,6). Moreover, chemotherapy has also been reported to increase post-operative wound complications in patients with advanced-stage resectable head and neck carcinoma (7,8).…”

Section: Introductionmentioning

confidence: 99%

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Post-operative pharyngocutaneous fistula after laryngectomy

et al. 2008

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Objectives: Although organ-preserving radiotherapy or chemoradiotherapy have offered good locoregional control, many patients still experience recurrent disease requiring salvage laryngectomy. The pharyngocutaneous fistulae (PCF) is a common and troublesome complication in the early postoperative period after laryngectomy.Here we evaluated the cause of PCF after laryngectomy, with special emphasis on radiotherapy and/or chemotherapy. Study Design: Retrospective chart review. Methods:

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“…Several reports represent evidences incriminating some of these factors, while others do not arrive at similar conclusions (4,5,6,11,13,14,19).…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Post-operative pharyngocutaneous fistula after laryngectomy

et al. 2008

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“…It is a complex, dynamic and systemic process, depending on the general health conditions of the patient with larynx neoplasm, and can be delayed by several intrinsic factors (age, preexistent diseases, radiotherapy, among others), which the nurse should identify in order to promote the continuity of the treatment process (9) . (10)(11)(12)(13)(14)(15)(16)(17)(18) .…”

Section: Results Of the Categories Extracted From The Studiesmentioning

confidence: 99%

“…Its development can double the average time of patient hospitalization, and consequently increase the costs (10,15) .…”

Section: Results Of the Categories Extracted From The Studiesmentioning

confidence: 99%

“…Considering an average hospital stay of 28 days, with average time for scarring of pharyngocutaneous fistulae of 36 days (10,(15)(16)(27)(28)(31)(32) , a significant increase in nursing care directed at these patients is observed during the whole period in hospital, because it is difficult to treat this problem, demanding more financial investments for hospital service maintenance. …”

Section: Results Of the Categories Extracted From The Studiesmentioning

confidence: 99%

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Pharyngocutaneous fistulae after total laryngectomy: a systematic review

Santana¹,

Sawada

2008

Rev. Latino-Am. Enfermagem

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Santana ME, Sawada NO. Pharyngocutaneous fistulae after total laryngectomy: a systematic review. Rev Regarding the epidemiology of larynx cancer, its incidence is higher in men than in women, predominantly affecting the age range between 50and 70 years old. For 2005, it is estimated that there will be 160,000 new cases in males and 22,000 in females, with an estimated number of 89,000 deaths among men and 12,000 among women (1) .The main forms of treatment for head and neck cancer include surgery and radiotherapy.Initially, these are used aiming for cure. However, in some circumstances, they serve as a palliative treatment, and may be associated to other therapies Evidence-based practice provides decision-making based on scientific knowledge.In view of the above, this systematic review was elaborated. This research method is an EBP resource, aimed at collecting and analyzing the scientific knowledge produced about the investigated theme. Systematic reviews identify finished studies that address a research topic and evaluate the results of these studies to reach conclusions about a body of knowledge. In trying to contribute to healthcare for surgical patients, aiming at minimizing the effects of pharyngocutaneous fistulae complications, this review was developed to identify the main treatments for pharyngocutaneous fistulae after total laryngectomy. METHODSystematic reviews enable researchers to evaluate the evidence available in literature, particularly in the clinical practice area, since the knowledge acquired in this investigation will contribute to the treatment and implementation of interventions with a view to better healthcare. The systematic review is "the application of scientific strategies that limit the biases for a systematic gathering, critical evaluation and synthesis of all the relevant studies about a specific topic".Nurses have developed studies using the systematic review as their method of choice, whose goal is to gather scientific knowledge to support the interventions that respond to patients' problems in clinical practice. METHODOLOGICAL PROCEDUREThe guiding question to construct the present systematic review was "What are the main treatments available for the patient with a pharyngocutaneous fistula after total laryngectomy".In order to reach the proposed objective, a 775The data were collected independently by two reviewers. These data were checked for agreement.The discordant results were solved by consensus. The data about study population, treatment and outcomes were collected by both reviewers, using an instrument to evaluate the articles, which was built by the researchers and was subject to face and content validation.After collecting data from the studies included in the systematic review, a descriptive analysis was performed, allowing the evaluation of the data from the studies included in this systematic review about the quantitative distribution of an event in the population. RESULTS Studies included in the systematic reviewThirty-five articles were obtained through the bibl...

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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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Pharyngocutaneous Fistula after Total Laryngectomy: Incidence, Cause, and Treatment

Cited by 93 publications

References 16 publications

Post-operative pharyngocutaneous fistula after laryngectomy

Post-operative pharyngocutaneous fistula after laryngectomy

Pharyngocutaneous fistulae after total laryngectomy: a systematic review

Complications in Head and Neck Surgery

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