Abstract
Objectives:
Pharyngeal fistula is the most common and troublesome postoperative complication after surgery of larynx, lower pharynx, and cervical esophagus carcinoma. This study aims to identify (1) the potential predisposing factors of pharyngeal fistula in laryngeal carcinoma patients after laryngectomy and (2) how nutritional support during treatment would contribute to improve prognosis.
Methods:
Retrospective review of 156 consecutive cases of laryngeal carcinoma patients who underwent laryngectomy from 2011 to 2013 at China-Japan Union Hospital, Jilin University. Nutritional support and other potential predisposing factors were analyzed between patients with and without pharyngeal fistula.
Results:
Among the 156 cases studied, 6.4% of patients demonstrated postoperative pharyngeal fistula. Many predisposing factors showed statistical significance (P < .05 or P < .001) in this study, such as smoking history (P < .05), neck dissection (P < .001), duration of operation (P < .05), postoperative serum albumin/total protein level (P < .001and P < .001, respectively), and body weight change after surgery (P < .05). Other factors, such as age, sex, hemoglobin level, tumor stage, surgical option, and hypertension, did not show any statistical significance. Furthermore, patients with malnutrition have much higher risk of developing pharyngeal fistula.
Conclusions:
The occurrence of pharyngeal fistula in laryngeal carcinoma patients is highly associated with the duration of smoking, neck dissection, duration of operation, postoperative serum albumin/total protein level, and body weight change. By optimizing the patients’ general preoperation conditions and synchronous nutritional support, it would largely enhance the therapeutic response, reduce incidence, and improve prognosis.
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