Abstract
Objectives:
Pharyngocutaneous fistula (PCF) is the most common postoperative complication following total laryngectomy. The aim of this study was to determine the effects of pharyngeal repair time and number of mucosal sutures used on the development of PCF.
Methods:
The medical records of 47 patients who underwent total laryngectomy were assessed. The pharyngeal repair time and the number of horizontal, vertical, and cricopharyngeal muscle sutures were recorded.
Results:
We observed the appearance of PCF in 14 patients (29.8%). The average time for pharyngeal repair in patients without PCF was 22 minutes, 21 seconds ± 5 minutes, and the average number of vertical, horizontal, and cricopharyngeal muscle sutures was 9.54 ± 2.6, 10.84 ± 2.3, and 7.36 ± 2.7, respectively. The average time for pharyngeal repair in patients with PCF was 22 minutes 59 seconds ± 5 minutes, and the average number of vertical, horizontal, and cricopharyngeal muscle sutures was 8.57 ± 2.6, 11.14 ± 2.1, and 8.45 ± 1.9, respectively. The differences in pharyngeal repair time and number of vertical, horizontal, and cricopharyngeal sutures between the 2 groups were not statistically significant (P > .05). As the number of vertical sutures increased, the fistulas developed later (P < .05). In addition, as the number of cricopharyngeal sutures increased, the duration of the fistula decreased (P < .05).
Conclusions:
Surgeons should not be in a hurry when they are repairing esophageal openings, and more sutures should be used in closing the cricopharyngeal muscle to decrease the duration of PCF. Using more vertical sutures when closing the esophagus delays the onset of fistulas.
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