فيستول فارنگوكوتانئوس پس از لارنژكتومي توتال در بيماران مراجعه كننده به بيمارستان امام خميني (ره)

Postlaryngectomy Pharyngocutaneus Fistula in Imam Khomeini Hospital

Background: Pharyngocutaneus fistula is the most common complication following total laryngectomy with an unknown multifactorial etiology. The present study was designed to determine the incidence and predisposing factors of pharyngocutaneus fistula. Methods: 76 patients who underwent total laryngectomy for laryngeal carcinoma were reviewed retrospectively. We evaluated factors potentially predisposing to fistula formation (age, sex, hypertension, congestive heart failure, pre- and post operative hemoglobin levels, tumor site, previous radiotherapy and chemotherapy, infection of surgical site, fever, concurrent neck dissection, smoking, drinking, peri-operative blood transfusion) using the chi-squared test, independent sample test and t-test. Findings: Pharyngocutaneus fistula was diagnosed in 10 patients (13.1%) within less than 4 weeks from surgery. Analysis showed that there were no statistically significant associations between fistula development and age, sex, hypertension, congestive heart failure, pre- and post operative hemoglobin levels, tumor site, previous radiotherapy and chemotherapy, concurrent neck dissection, smoking, drinking and peri operative blood transfusion. Infection of surgical margins and fever increased the risk of fistula development. Conclusion: The results show that infection of the surgical site and fever were associated with fistula formation. Given that fistula formation increases patients morbidity and hospital stay, prevention of surgical site infection and fever should be considered with an increased risk of pharyngocutaneus fistula formation,