Post-operative pharyngocutaneous fistula after laryngectomy
Post-operative pharyngocutaneous fistula after laryngectomy
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DOI：
10.1016/j.anl.2007.06.002
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发表时间：
2008-06-01
影响因子：
1.7
通讯作者：
Yoshizaki, Tomokazu
中科院分区：
文献类型：
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作者：
Wakisaka, Naohiro;Murono, Shigeyuki;Yoshizaki, Tomokazu
目的：虽然保留器官的放射治疗或化学放射治疗提供了良好的局部控制，许多患者仍然经历需要挽救性喉切除术的复发性疾病。咽皮瘘（PCF）是喉切除术后早期常见而棘手的并发症。在这里，我们评估了喉切除术后PCF的原因，特别强调放疗和/或化疗。患者和方法：共63例连续接受挽救性全喉切除术的喉鳞状细胞癌在金泽大学医院从1990年至2005年进行了审查。其中40例接受了初次全喉切除术（PL）。10例患者接受单纯放疗（SL-RT）和13例患者接受同步放化疗（SL-CRT），然后进行挽救性喉切除术。结果：总体而言，17 63例（27.0%）发展PCF喉切除术后。Fisher精确检验显示，与PL（7/40，17.5%）相比，SL-CRT（7/13，53.8%）中PCF形成显著增加（p = 0.0252）。与SL-RT（3/10，30.0%）相比，SL-CRT（7/13，53.8%）中PCF形成无显著增加（p = 0.4015），与PL（7/40，17.5%）相比，SL-RT（3/10，30.0%）中PCF形成无显著增加（p = 0.3969）。Mann-Whitney U检验显示，SL-CRT PCF（121.2 ± 95.0天）的PCF持续时间显著长于PL（39.0 ± 55.3天）（p = 0.0298）或SL-RT（28.0 ± 16.2天）（p = 0.0325）。然而，我们没有发现一个显着差异的持续时间PCF方面PL（39.0 +/- 55.3天）和SL-RT（28.0 +/- 16.2天）（p = 0.4367）。结论：虽然放疗或化疗只有有限的影响PCF的形成，同时放化疗显着增加PCF的形成。放疗加化疗可延迟PCF闭合。(C)2007爱思唯尔爱尔兰有限公司保留所有权利。
Objectives: Although organ-preserving radiotherapy or chemoradiotherapy has offered good locoregional control, many patients still experience recurrent disease requiring salvage laryngectomy. The pharyngocutaneous fistula (PCF) is a common and troublesome complication in the early post-operative period after laryngectomy. Here, we evaluated the cause of PCF after laryngectomy, with special emphasis on radiotherapy and/or chemotherapy.Patients and methods: A total of 63 consecutive patients undergoing salvage total laryngectomy for squamous cell carcinoma of the larynx at Kanazawa University Hospital from 1990 to 2005 were reviewed. Forty of the 63 had received primary total laryngectomy (PL). Ten patients underwent radiotherapy alone (SL-RT) and 13 patients underwent concurrent chemoradiotherapy (SL-CRT) followed by salvage laryngectomy.Results: Overall, 17 of the 63 patients (27.0%) developed PCF after laryngectomy. Fisher's exact test showed a significant increase of PCF formation in SL-CRT (7/13, 53.8%) compared with PL (7/40, 17.5%) (p = 0.0252). There were non-significant increases of PCF formation both in SL-CRT (7/13,53.8%) compared with SL-RT (3/10,30.0%) (p = 0.4015), and also in SL-RT (3/10,30.0%) compared with PL (7/40, 17.5%) (p = 0.3969). The Mann-Whitney U-test showed that the duration of PCF was significantly longer for SL-CRT PCF (121.2 +/- 95.0 days) compared with those for PL (39.0 +/- 55.3 days) (p = 0.0298) or SL-RT (28.0 +/- 16.2 days) (p = 0.0325). However, we did not find a significant difference in the duration of PCF with respect to PL (39.0 +/- 55.3 days) and SL-RT (28.0 +/- 16.2 days) (p = 0.4367).Conclusions: Although radiotherapy or chemotherapy has only a limited impact on PCF formation, concurrent chemoradiotherapy significantly increases PCF formation. The addition of chemotherapy to irradiation delays PCF closure. (C) 2007 Elsevier Ireland Ltd. All rights reserved.