A simple drainage technique to manage pharyngocutaneous fistula following laryngectomy

2019 ◽  
Vol 44 (6) ◽  
pp. 1211-1213
Author(s):  
Samuel T. Roberts ◽  
Megan Hobson ◽  
Robert Eisenberg
Keyword(s):  
Pharyngocutaneous Fistula ◽  
Simple Drainage ◽  
Drainage Technique

Perifascial Areolar Tissue (PAT) Grafts for Closures of Pharyngocutaneous Fistula and Laryngocutaneous Fistula

2015 ◽  
Vol 66 (4) ◽  
pp. 262-266
Author(s):  
Hiroko Monobe ◽  
Masato Mochiki ◽  
Katsumi Takizawa ◽  
Kazunari Okada
Keyword(s):  
Areolar Tissue ◽  
Pharyngocutaneous Fistula

scholarly journals Survival and pleurodesis outcome in patients with malignant pleural effusion – a systematic review

2021 ◽  
Vol 6 (1) ◽  
pp. 1-5
Author(s):  
Maged Hassan ◽  
Elinor Harriss ◽  
Rachel M. Mercer ◽  
Najib M. Rahman
Keyword(s):  
Systematic Review ◽  
Pleural Effusion ◽  
Survival Benefit ◽  
Malignant Pleural Effusion ◽  
Risk Of Bias ◽  
Common Condition ◽  
Survival Difference ◽  
Range Difference ◽  
Simple Drainage

Abstract Malignant pleural effusion (MPE) is a common condition that presents with progressive breathlessness. Long term solutions are often required due to recurrence of effusion after simple drainage. Pleurodesis is one of the main options resorted to for long term control of MPE. There is data to suggest there may be a survival benefit for patients with MPE who achieve successful pleurodesis. A systematic review was carried out to explore this correlation and results suggest that there could be a survival difference according to pleurodesis outcome in patients with MPE. Fifteen studies (reported in 13 papers) were included; 13 (86.6%) of the studies showed survival difference in favour of pleurodesis success. The median [interquartile range] difference in survival between the two groups among the different studies was five [3.5–5.8] months. Most of the included studies suffered moderate to severe risk of bias and, thus, large prospective studies of patients undergoing pleurodesis are required to ascertain this effect.

scholarly journals Modified vacuum‐assisted closure ( EndoVAC ) therapy for treatment of pharyngocutaneous fistula: A case series and a review of the literature

Head & Neck ◽  
2021 ◽  
Author(s):  
Teresa Bernadette Steinbichler ◽  
Dolores Wolfram ◽  
Annette Runge ◽  
Roland Hartl ◽  
Daniel Dejaco ◽  
...  
Keyword(s):  
Case Series ◽  
Pharyngocutaneous Fistula ◽  
Review Of The Literature ◽  
Vacuum Assisted Closure

scholarly journals A New Classification System to Predict Functional Outcome after Laryngectomy and Laryngopharyngectomy

Cancers ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1474
Author(s):  
Stefan Grasl ◽  
Elisabeth Schmid ◽  
Gregor Heiduschka ◽  
Markus Brunner ◽  
Blažen Marijić ◽  
...  
Keyword(s):  
Functional Outcome ◽  
Classification System ◽  
Salvage Surgery ◽  
Tumor Resection ◽  
Previous Treatment ◽  
Extent Of Resection ◽  
Voice Rehabilitation ◽  
Pharyngocutaneous Fistula ◽  
Oral Nutrition

(1) Objective: To evaluate long-term functional outcome in patients who underwent primary or salvage total laryngectomy (TL), TL with partial (TLPP), or total pharyngectomy (TLTP), and to establish a new scoring system to predict complication rate and long-term functional outcome; (2) Material and Methods: Between 1993 and 2019, 258 patients underwent TL (n = 85), TLPP (n = 101), or TLTP (n = 72). Based on the extent of tumor resection, all patients were stratified to (i) localization I: TL; II: TLPP; III: TLTP and (ii) surgical treatment (A: primary resection; B: salvage surgery). Type and rate of complication and functional outcome, including oral nutrition, G-tube dependence, pharyngeal stenosis, and voice rehabilitation were evaluated in 163 patients with a follow-up ≥ 12 months and absence of recurrent disease; (3) Results: We found 61 IA, 24 IB, 63 IIA, 38 IIB, 37 IIIA, and 35 IIIA patients. Complications and subsequently revision surgeries occurred most frequently in IIIB cases but rarely in IA patients (57.1% vs. 18%; p = 0.001 and 51.4% vs. 14.8%; p = 0.002), respectively. Pharyngocutaneous fistula (PCF) was the most common complication (33%), although it did not significantly differ among cohorts (p = 0.345). Pharyngeal stenosis was found in 27% of cases, with the highest incidence in IIIA (45.5%) and IIIB (72.7%) patients (p < 0.001). Most (91.1%) IA patients achieved complete oral nutrition compared to only 41.7% in class IIIB patients (p < 0.001). Absence of PCF (odds ratio (OR) 3.29; p = 0.003), presence of complications (OR 3.47; p = 0.004), and no need for pharyngeal reconstruction (OR 4.44; p = 0.042) represented independent favorable factors for oral nutrition. Verbal communication was achieved in 69.3% of patients and was accomplished by the insertion of voice prosthesis in 37.4%. Acquisition of esophageal speech was reached in 31.9% of cases. Based on these data, we stratified patients regarding the extent of surgery and previous treatment into subgroups reflecting risk profiles and expectable functional outcome; (4) Conclusions: The extent of resection accompanied by the need for reconstruction and salvage surgery both carry a higher risk of complications and subsequently worse functional outcome. Both factors are reflected in our classification system that can be helpful to better predict patients’ functional outcome.

scholarly journals Does Usage of Salivary Bypass Tube Could Reduce the Risk for Pharyngocutaneous Fistula in Laryngopharyngectomy? A Systematic Review and Meta-Analysis

Cancers ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 2827
Author(s):  
Blažen Marijić ◽  
Stefan Grasl ◽  
Matthaeus Ch. Grasl ◽  
Muhammad Faisal ◽  
Boban M. Erovic ◽  
...  
Keyword(s):  
Systematic Review ◽  
Beneficial Effect ◽  
Meta Analysis ◽  
Pharyngocutaneous Fistula

To evaluate the effect of salivary bypass tube (SBT) usage on the occurrence of pharyngocutaneous fistula (PCF) in patients after a laryngopharyngectomy, a total of 20 studies, published between 1988 and 2021, were identified including 2946 patients. We performed a meta-analysis assessing the risk of PCF occurrence in patients after SBT application compared to those without. PCF occurred in 26.8% of cases (669/2496) and SBT was applied in 33.0% of patients (820/2483). There was an overall trend towards lower PCF rates when using SBTs (22.2% vs. 35.3%; p = 0.057). We further selected five studies, comprising 580 patients who underwent laryngopharyngectomies, for meta-analysis showing that application of SBT reduced the risk of PCF formation (OR 0.46; 95% CI 0.18–1.18; p = 0.11). The meta-analysis demonstrates a beneficial effect of SBT insertion on PCF formation in patients after laryngopharyngectomy.

Fibrin glue–reinforced closure of postlaryngectomy pharyngocutaneous fistula

2002 ◽  
Vol 23 (6) ◽  
pp. 368-373 ◽  
Author(s):  
Sam Wiseman ◽  
Wesley Hicks ◽  
Thom Loree ◽  
Mazin Al-kasspooles ◽  
Nestor Rigual
Keyword(s):  
Fibrin Glue ◽  
Pharyngocutaneous Fistula

Postlaryngectomy Pharyngocutaneous Fistula: Incidence, Predisposing Factors, and Therapy

2005 ◽  
Vol 133 (5) ◽  
pp. 689-694 ◽  
Author(s):  
Jacopo Galli ◽  
Eugenio De Corso ◽  
Mariangela Volante ◽  
Giovanni Almadori ◽  
Gaetano Paludetti
Keyword(s):  
Risk Factor ◽  
Total Laryngectomy ◽  
Radical Neck Dissection ◽  
Predisposing Factors ◽  
Spontaneous Closure ◽  
Pharyngocutaneous Fistula ◽  
Systemic Diseases ◽  
Surgical Closure ◽  
Number Of Factors ◽  
Wait And See

OBJECTIVE: The pharyngocutaneous fistula (PCF) is a serious complication after total laryngectomy, and its etiology is not well understood yet. The aim of our study was to evaluate predisposing factors, incidence, and management of this complication. STUDY DESIGN AND SETTING: This was a retrospective study of 268 patients who underwent total laryngectomy in our clinic (January 1990-December 2001). A number of factors potentially predisposing to PCF formation were evaluated. RESULTS: A PCF was observed in 16% of patients. Systemic diseases, previous radiotherapy, supraglottic origin of tumor, and concurrent radical neck dissection were significantly associated with PCF. Spontaneous closure was noted in 28 patients, whereas a surgical closure was necessary in 15 patients. CONCLUSIONS: In presence of a specific risk factor, PCF can be expected; nevertheless, its prevention remains very difficult. Moreover, given the high percentage of spontaneous closure, we suggest the “wait and see” approach for 28 days before proceeding with a surgical approach.

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