PDF(Pubmed)
Abstract：
UNASSIGNED: Pharyngocutaneous fistula (PCF) is the most common complication to follow total laryngectomy (TL) and is associated with increases in length of hospital stay and with a need for revision surgery or readmission, as well as with delays in return to oral diet. Patients who require salvage TL (STL) or primary (chemo)radiation therapy are at higher risk for developing PCF. Due to the quality-of-life burden of PCF on patients, limiting this occurrence is crucial.
UNASSIGNED: We conducted a retrospective cohort study of patients undergoing STL with placement of Montgomery salivary bypass tube (MSBT)™ for at least 2 weeks duration between 2013 and 2017 at a single institution. Our patients all underwent free flap reconstruction. Our primary outcome of interest was development of PCF. Secondary outcomes included demographics, previous treatment, base of tongue (BOT) involvement, extent of defect, concurrent neck dissection (ND), and margin status. Univariate χ 2 analysis was used to evaluate factors associated with PCF.
UNASSIGNED: Forty-four patients underwent STL with Montgomery tube placement and free flap reconstruction. Eight developed PCF (18.2%). The average age was 61.6 years; 36 patients were male (81.8%), whereas eight patients were female (18.2%). There was no association between PCF and previous chemoradiation versus radiation (15.8% vs. 33.3%, P < 0.30), BOT involvement versus not (11.1 vs. 22.2%, P < 0.38), circumferential versus partial defect (18.8% vs. 17.9%, P < 0.94), ND versus none (10% vs. 25%, P < 0.20), or margin status.
UNASSIGNED: PCF complicated 18.2% of STL cases at our institution and was not associated with differences in primary treatment modality, presence of concomitant ND, extent of pharyngeal defect, BOT involvement, or positive frozen or permanent surgical margin.
UNASSIGNED: We conducted a retrospective cohort study of patients undergoing STL with placement of Montgomery salivary bypass tube (MSBT)™ for at least 2 weeks duration between 2013 and 2017 at a single institution. Our patients all underwent free flap reconstruction. Our primary outcome of interest was development of PCF. Secondary outcomes included demographics, previous treatment, base of tongue (BOT) involvement, extent of defect, concurrent neck dissection (ND), and margin status. Univariate χ 2 analysis was used to evaluate factors associated with PCF.
UNASSIGNED: Forty-four patients underwent STL with Montgomery tube placement and free flap reconstruction. Eight developed PCF (18.2%). The average age was 61.6 years; 36 patients were male (81.8%), whereas eight patients were female (18.2%). There was no association between PCF and previous chemoradiation versus radiation (15.8% vs. 33.3%, P < 0.30), BOT involvement versus not (11.1 vs. 22.2%, P < 0.38), circumferential versus partial defect (18.8% vs. 17.9%, P < 0.94), ND versus none (10% vs. 25%, P < 0.20), or margin status.
UNASSIGNED: PCF complicated 18.2% of STL cases at our institution and was not associated with differences in primary treatment modality, presence of concomitant ND, extent of pharyngeal defect, BOT involvement, or positive frozen or permanent surgical margin.
摘要：
咽部皮肤瘘(PCF)是全喉切除术(TL)后最常见的并发症，与住院时间增加以及需要进行翻修手术或再次入院有关。以及延迟恢复口服饮食。需要抢救TL（STL）或主要（化学）放射治疗的患者发生PCF的风险更高。由于PCF对患者的生活质量负担，限制这种情况是至关重要的。
■我们在2013年至2017年期间，对接受STL并放置Montgomery唾液旁路管（MSBT）™的患者进行了一项回顾性队列研究。我们的患者都进行了游离皮瓣重建。我们感兴趣的主要结果是PCF的发展。次要结果包括人口统计学，以前的治疗,舌根（BOT）参与，缺陷的程度，并发颈淋巴结清扫术（ND），和保证金状态。单因素χ2分析用于评估PCF的相关因素。
■44例患者接受蒙哥马利置管和游离皮瓣重建STL。8个发展了PCF（18.2%）。平均年龄为61.6岁；36例患者为男性（81.8%），而8例患者为女性(18.2%)。PCF与先前的放化疗和放疗之间没有关联(15.8%与33.3%,P<0.30),BOT参与与不参与（11.1与22.2%,P<0.38)，周向缺损与部分缺损(18.8%与17.9%,P<0.94)，ND与无（10%与25%,P<0.20),或保证金状态。
■PCF使我们机构的STL病例中有18.2％并发，并且与主要治疗方式的差异无关。伴随ND的存在，咽部缺损程度,BOT参与,或阳性冻结或永久性手术切缘。
■我们在2013年至2017年期间，对接受STL并放置Montgomery唾液旁路管（MSBT）™的患者进行了一项回顾性队列研究。我们的患者都进行了游离皮瓣重建。我们感兴趣的主要结果是PCF的发展。次要结果包括人口统计学，以前的治疗,舌根（BOT）参与，缺陷的程度，并发颈淋巴结清扫术（ND），和保证金状态。单因素χ2分析用于评估PCF的相关因素。
■44例患者接受蒙哥马利置管和游离皮瓣重建STL。8个发展了PCF（18.2%）。平均年龄为61.6岁；36例患者为男性（81.8%），而8例患者为女性(18.2%)。PCF与先前的放化疗和放疗之间没有关联(15.8%与33.3%,P<0.30),BOT参与与不参与（11.1与22.2%,P<0.38)，周向缺损与部分缺损(18.8%与17.9%,P<0.94)，ND与无（10%与25%,P<0.20),或保证金状态。
■PCF使我们机构的STL病例中有18.2％并发，并且与主要治疗方式的差异无关。伴随ND的存在，咽部缺损程度,BOT参与,或阳性冻结或永久性手术切缘。
