gms | German Medical Science

87th Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

04.05. - 07.05.2016, Düsseldorf

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Different pharynx closure techniques in laryngectomy as a risk for pharyngocutaneous fistula

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  • corresponding author Blagovesta Todorova - Medical University Varna, Varna, Bulgaria
  • Darina Ivanova - Department of imaging diagnostics and radiotherapy, Medical University Prof. Dr., Varna, Bulgaria
  • Nikolay Sapundzhiev - Department of neurosurgery and ENT diseases, Medical University Prof. Dr. P. Sto, Varna, Bulgaria
  • Petar Petrov - Department of imaging diagnostics and radiotherapy, Medical University Prof. Dr., Varna, Bulgaria
  • Boyan Balev - Department of imaging diagnostics and radiotherapy, Medical University Prof. Dr., Varna, Bulgaria
  • Emanuela Mutafova - .Faculty of public health, Medical University Prof. Dr. P. Stoyanov – Varna, Bul, Varna, Bulgaria

Deutsche Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie. 87. Jahresversammlung der Deutschen Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie. Düsseldorf, 04.-07.05.2016. Düsseldorf: German Medical Science GMS Publishing House; 2016. Doc16hnod237

doi: 10.3205/16hnod237, urn:nbn:de:0183-16hnod2370

Published: March 30, 2016

© 2016 Todorova et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

Text

Introduction: One of the most frequent and troublesome complication following laryngectomy is pharyngocutaneous fistula (PCF). There are a lot of different risk factors for PCF suspected and evaluated, but only few proven.

Objective: Evaluation the role of different pharynx closure techniques on PCF-incidence.

Material and method: The charts of 92 patients, treated for carcinoma of the larynx with laryngectomy at MBAL “Sv. Marina” between july 2007 and december 2014 (86 males, 6 females, aged 61.9 +/- 8.2 years; T4=39, T3=53; N0=71 and N+ =21) were evaluated retrospectively. Three types of closure of the neohypopharynx were used: linear plasty in 31 cases, Y-shaped plasty in 46 cases and atypical type of closure with local tissues being stretched beyond the midline in the remaining 6 cases (called ZZ, TL or L). The primary endpoint was development of clinically evident PCF. The analysis was performed via Student’s t-test.

Results: The overall incidence of PCF was 7.53%. 1/46 (2.17%) in the Y-plasty group, 3/31 (9.68%) in the I-plasty group and 1/6 (16.67%) in the atypical plasty group developed PCF. The statistical result of the analysis does not find significance in the development of PCF between the groups.

Conclusion: The type of the suture line for closure of the neohypopharynx in previously unirradiated patients with otherwise uniform surgical technique does not appear to be a risk factor for PCF.

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