Risk factors in the apparition of pharyngocutaneous fistula

Abstract

Introduction: pharyngocutaneous fistula is the most frequent post-surgery complication of the total laryngectomy. It increases morbimortality, delays the administration of the oncological treatment and rebounds in the patient’s psychological sphere.

Objective: to know the behavior of the pharyngocutaneous fistula in patients with total laryngectomy.

Materials and methods: a retrospective, descriptive, observational study was carried out in the University Hospital “Comandante Faustino Pérez”, in the period from January 2010 until December 2015. The universe were 143 patients who undergone a laryngectomy. The studied variables were age, sex, nutritional status before the surgery, tumor stage, radiations, tracheotomy, neck management before surgery, and fistula evolution.

Results: 28 % of the patients presented post-surgery fistula, predominantly among males (92.3 %). Normal weight patients were 56.6 %; 70 % were in the IV stage. 72.5 % of the patients were irradiated and 95 % undergone tracheotomy before the surgery. 37.5 % of them undergone cervical resection. In 70 % of the patients, the fistula appeared after 8-14 days.   

Conclusions: the incidence of the pharyngocutaneous fistula is higher in the male sex and the 60-69 years age-group. The highest incidence occurred in 2015. The advanced stage of the tumor, the presence of tracheotomy, the nutritional status and previous irradiation were the factors that had more incidences on pharyngocutaneous fistulae. The closure of the fistula was spontaneous in most of the patients, with a good evolution.