Meta-analysis of risk factors associated with pharyngocutaneous fistulas following total laryngectomy

Background: To investigate the risk factors for pharyngocutaneous fistulas following total laryngectomy. Methods: PubMed, Web of Science, CNKI, Medline and Wanfang database were utilized to conduct a systematic literature research. Further, sensitivity and publication bias were analyzed to comprehensively estimate the risk factors associated with pharyngocutaneous fistulas following total laryngectomy. Results: Of the 112 studies identified, 25 were included in this analysis. The results showed that age (OR = 0.21, 95% CI 0.11-0.39, P<0.00001), smoking (OR = 3, 95% CI 1.54-5.84, P<0.00001), T-stage (OR = 0.3, 95% CI 0.22-0.4, P<0.00001), previous radiotherapy (OR = 0.31, 95% CI 0.23-0.44, P<0.000001) and preoperative albumin (OR = 0.28, 95% CI 0.16-0.47, P<0.00001) were risk factors associated with pharyngocutaneous fistulas. Conclusions: This review is a comprehensive analysis of the risk factors associated with pharyngocutaneous fistulas following total laryngectomy. Age, smoking, T-stage, previous radiotherapy and preoperative albumin were found to be the risk factors.