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Abstract：
Surgeons have developed various reconstructive techniques to minimize the rate of pharyngocutaneous fistula and optimize functional outcome after salvage laryngectomy or laryngopharyngectomy.
Multicenter retrospective review at 33 institutions of 486 patients with a history of squamous cell carcinoma (SCC) of the larynx or hypopharynx previously treated with primary chemoradiotherapy (CRT) who required salvage surgery. Outcomes evaluated were overall fistula rate, fistula requiring reoperation, and 12-month speech and swallowing function.
Primary closure of the hypopharynx was associated with a statistically higher overall fistula rate and fistula requiring reoperation compared to reconstruction with vascularized tissue augmentation. Vascularized tissue augmentation with muscle led to worse 12-month \"understandability of speech\" and \"nutritional mode\" scores compared to vascularized tissue augmentation without muscle.
Vascularized tissue augmentation reduces the overall fistula rate and fistula requiring reoperation but vascularized tissue augmentation with muscle may impair speech and swallowing outcomes.
Multicenter retrospective review at 33 institutions of 486 patients with a history of squamous cell carcinoma (SCC) of the larynx or hypopharynx previously treated with primary chemoradiotherapy (CRT) who required salvage surgery. Outcomes evaluated were overall fistula rate, fistula requiring reoperation, and 12-month speech and swallowing function.
Primary closure of the hypopharynx was associated with a statistically higher overall fistula rate and fistula requiring reoperation compared to reconstruction with vascularized tissue augmentation. Vascularized tissue augmentation with muscle led to worse 12-month \"understandability of speech\" and \"nutritional mode\" scores compared to vascularized tissue augmentation without muscle.
Vascularized tissue augmentation reduces the overall fistula rate and fistula requiring reoperation but vascularized tissue augmentation with muscle may impair speech and swallowing outcomes.
摘要：
外科医生已经开发了各种重建技术，以最大程度地减少咽皮瘘的发生率，并优化挽救性喉切除术或喉咽切除术后的功能结局。
对33个机构的486例有喉或下咽鳞状细胞癌（SCC）病史的患者进行多中心回顾性分析，这些患者以前接受过初级放化疗（CRT）治疗，需要进行挽救性手术。结果评估为整体瘘发生率，瘘管需要再次手术,和12个月的言语和吞咽功能。
与血管化组织增强重建相比，下咽的初次闭合与统计学上更高的总瘘率和需要再次手术的瘘相关。与没有肌肉的血管化组织增强相比，有肌肉的血管化组织增强导致12个月的“言语可理解性”和“营养模式”评分更差。
血管化组织增强降低了整体瘘管率和瘘管需要再次手术，但血管化组织增强肌肉可能会损害言语和吞咽结果。
对33个机构的486例有喉或下咽鳞状细胞癌（SCC）病史的患者进行多中心回顾性分析，这些患者以前接受过初级放化疗（CRT）治疗，需要进行挽救性手术。结果评估为整体瘘发生率，瘘管需要再次手术,和12个月的言语和吞咽功能。
与血管化组织增强重建相比，下咽的初次闭合与统计学上更高的总瘘率和需要再次手术的瘘相关。与没有肌肉的血管化组织增强相比，有肌肉的血管化组织增强导致12个月的“言语可理解性”和“营养模式”评分更差。
血管化组织增强降低了整体瘘管率和瘘管需要再次手术，但血管化组织增强肌肉可能会损害言语和吞咽结果。
