COMPARISON OF PHARYNGOCUTANEOUS FISTULA BETWEEN PATIENTS FOLLOWED BY PRIMARY LARYNGOPHARYNGECTOMY AND SALVAGE LARYNGOPHARYNGECTOMY FOR ADVANCED HYPOPHARYNGEAL CANCER

被引:62
作者
Tsou, Yung-An [1 ]
Hua, Chun-Hung [1 ]
Lin, Meng-Hung [2 ]
Tseng, Hsien-Chang [1 ]
Tsai, Ming-Hsui [1 ]
Shaha, Ashok [3 ]
机构
[1] China Med Univ Hosp, Dept Otolaryngol, Taichung, Taiwan
[2] China Med Univ, Inst Environm Hlth, Taichung, Taiwan
[3] Mem Sloan Kettering Canc Ctr, New York, NY 10021 USA
来源
HEAD AND NECK-JOURNAL FOR THE SCIENCES AND SPECIALTIES OF THE HEAD AND NECK | 2010年 / 32卷 / 11期
关键词
pharyngocutaneous fistula; hypopharyngeal cancer; radiation therapy; laryngopharyngectomy; hypo-albuminemia; TOTAL LARYNGECTOMY; PREDISPOSING FACTORS; RISK-FACTORS; TISSUE; RECONSTRUCTION; COMPLICATIONS; SURGERY; DEFECTS; NECK; HEAD;
D O I
10.1002/hed.21352
中图分类号
R76 [耳鼻咽喉科学];
学科分类号
100213 ;
摘要
Background. We analyzed the incidence rate, possible etiology, and management of pharyngocutaneous fistula after laryngopharyngectomy between hypopharyngeal cancer patients who received surgery first and subsequently concurrent chemoradiation therapy (CCRT) and those who received COAT first followed by surgical salvage. Methods. This is a case cohort, retrospective study collected in a tertiary medical center from January 1996 to July 2007. Results. From the total of 160 patients, 52 patients (32.5%) developed pharyngocutaneous fistula. There is a significant difference between the pharyngocutaneous fistula rate of those with initial COAT and the initial surgery groups. By univariate analysis and multiple logistic regression, tests revealed that preoperative radiation and hypo-albuminemia are risk factors for pharyngocutaneous fistula. A prolonged hospital course was noted among patients in the fistula group, especially when they received surgical repair, had hypo-albuminemia (albumin, <2.5 g/dL), or received preoperative radiation therapy (pre-OPRT). Conclusions. Preoperative radiation therapy and hypo-albuminemia increase the fistula rate significantly. A prolonged hospital course was noted among all fistula patients. (C) 2010 Wiley Periodicals, Inc. Head Neck 32: 1494-1500, 2010
引用
收藏
页码:1494 / 1500
页数:7
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