Risk Factors and Incidence of Pharyngocutaneous Fistula
Md. Abdus Sattar *
Head-Neck Surgery Division, Bangladesh Medical University, Bangladesh.
Belayat Hossain Siddiquee
Head-Neck Surgery Division, Bangladesh Medical University, Bangladesh.
*Author to whom correspondence should be addressed.
Abstract
Background: Pharyngocutaneous fistula remains a significant postoperative complication following total laryngectomy, contributing substantially to patient morbidity, prolonged hospital stay, delayed adjuvant therapy, and increased healthcare costs.
Objective: This study has been conducted to establish the incidence, risk factors, and their relation to the management of pharyngocutaneous fistula (PCF). Thorough knowledge of modifiable, possibly modifiable and non-modifiable risk factors is essential for the appropriate management of PCF.
Design and Setting: This is an Observational, Cross-sectional study which is conducted in the Department of Otolaryngology and Head-Neck Surgery of Bangladesh Medical University (BMU), the only functioning, service and research-oriented medical university of Bangladesh since 2006-2017.
Methods: All patients treated with Total laryngectomy for advanced laryngeal carcinoma and Total Thyroidectomy for advanced thyroid disease with extrathyroidal extension were included in this study.
Results: The duration of this study was 12 years (2006–2017). A total of 249 patients were included, of whom 48 (19.28%) developed PCF. Irradiated patients with multiple co-morbidities were more susceptible to developing PCF.
Conclusion: High occurrence of pharyngocutaneous fistula, mostly due to the advanced stage of disease, various levels of surgical expertise and post irradiated patients with multiple comorbidities.
Keywords: Pharyngocutaneous Fistula (PCF), laryngectomy, Pectoralis Major Myocutaneous Flap (PMMC), risk factor, thyroid