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Risk factors for pharyngocutaneous fistula formation: a study focused on pharyngeal reconstruction technique

Published online by Cambridge University Press:  21 October 2024

Yagmur Barcan Open the ORCID record for Yagmur Barcan [Opens in a new window] ,
Yalcin Alimoglu ,
Gokhan Gurbuz  and
Omer Uysal
Yagmur Barcan*
Affiliation:
Health Sciences University Haseki Training and Research Hospital, Department of Otorhinolaryngology, Istanbul, Turkey
Yalcin Alimoglu
Affiliation:
Basaksehir Cam and Sakura City Hospital, Department of Otorhinolaryngology, Istanbul, Turkey
Gokhan Gurbuz
Affiliation:
Behcelievler State Hospital, Department of Otorhinolaryngology, Istanbul, Turkey
Omer Uysal
Affiliation:
Istanbul University–Cerrahpasa, Cerrahpasa Faculty of Medicine, Department of Basic Medical Sciences, Istanbul, Turkey
*
Corresponding author: Yagmur Barcan; Email: [email protected]
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Abstract

Objective

This study investigated the risk factors for developing pharyngocutaneous fistula, the most common complication following total laryngectomy.

Methods

We included all patients who underwent total laryngectomy and bilateral neck dissection from 2009 to 2021. Patients excluded were those with hypopharyngeal involvement, total or partial pharyngectomy, base of the tongue resection, large pharyngeal defects requiring free/pedicle flap reconstruction, or salvage laryngectomy.

Results

A total of 164 patients participated in the study. Multivariate regression analysis identified two independent predictors of pharyngocutaneous fistula formation: pharyngeal reconstruction with simple interrupted sutures (odds ratio: 3.12, 95 per cent confidence interval: 1.31–17.00, p = 0.010) and radical neck dissection (odds ratio: 3.16, 95 per cent confidence interval: 1.13–8.82, p = 0.028).

Conclusions

Our findings suggest that pharyngeal reconstruction using simple interrupted sutures and radical neck dissection are independent risk factors for pharyngocutaneous fistula development. Based on this, we recommend using the modified Cushing suture technique over simple interrupted sutures due to its association with a significantly lower pharyngocutaneous fistula rate.

Keywords

larynx cancersuture techniquespharyngocutaneous fistulalaryngectomy
Type
Main Article
Information
The Journal of Laryngology & Otology , Volume 139 , Issue 2 , February 2025 , pp. 134 - 140
Copyright
Copyright © The Author(s), 2024. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

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Footnotes

Yagmur Barcan takes responsibility for the integrity of the content of the paper

Presented at 44thTurkish National Otorhinolaryngology Head and Neck Surgery Congress, 15–19 November 2023, Antalya, Turkey.

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