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International Bulletin of Otorhinolaryngology

Meta-Analysis of the Incidence of Pharygeocutaneous Fistulas In Laryngectomized Patients

V. Marinov, G. Cheema, H. Ali, J. Kasaboglu

Abstract

Background: Laryngeal cancer is the seventh most common cancer worldwide, with significant morbidity and mortality. Treatment often involves total laryngectomy, leading to complications such as Pharygeocutaneous fistulas (PCF) in 10-20% of cases. PCFs impede recovery and worsen patient outcomes, with risk factors including
nutritional status, surgical techniques and pre-operative radiotherapy.
Methods: A retrospective analysis of 19 studies including over 5000 patients was conducted to evaluate the incidence of PCF in laryngectomized patients. The study focused on laryngectomies performed for laryngeal carcinoma. Examining risk factors such as age, nutritional status and deficiencies, radiotherapy and surgical techniques. Studies unrelated to oncological treatment or those published before 2000 were excluded.
Results: No significant difference in the rate of PCF was found between oral feeding and feeding via a Nasogastric tube (NGT). Hypoalbuminemia was a notable risk factor in the development of PCF. Advanced tumour stages (T3 and T4) were linked to a higher incidence of PCF, though statical significance varied. Continuous suturing and mechanical sutures showed reduced PCF risk compared to interrupted and manual sutures.
Conclusion: PCF are the most common complication post-laryngectomy, with factors like hypoalbuminemia, low haemoglobin and preoperative radiotherapy increasing the risk. Pre-operative optimization of the nutritional and haematological status is recommended to lower PCF incidence and improve patient outcomes and quality of life.

Keywords

Laryngeal carcinoma, Pharygeocutaneous fistula, NGT and feeding

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DOI: http://dx.doi.org/10.14748/orl.v20i1.10012

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