Pharyngocutaneous Fistula after Laryngectomy: An Umbrella Review to Uncover Lacunae in Meta-Analyses

Karthik Nagaraja Rao, Ripudaman Arora, Ambesh Singh, Prajwal Dange, Nitin M. Nagarkar
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Abstract

Objective—The objective of this study was to systematically assess meta-analyses to determine the lacunae in the literature for PCF following laryngectomy. Methods—Bibliometric analysis were carried out on meta-analyses on PCF after total laryngectomy for laryngeal cancer in the PubMed database. Results—Twenty-four meta-analyses were considered eligible and chosen for analysis. Six meta-analyses (25%) focused on the risk factors for PCF in TL. Four meta-analyses (16.6%) focused on the role of the onlay flap. Four meta-analyses (16.6%) focused on the timing of feed initiation. Three meta-analyses (12.5%) focused on using a stapler for pharyngeal closure. Two meta-analyses focused on types of pharyngeal reconstruction. Other meta-analyses analyzed the use of salivary bypass tubes, the method of pharyngeal closure, organ preservation protocols on PCF, primary and secondary TEP, and the effect of non-surgical treatment on PCF. Conclusion—Despite plenty of published meta-analyses, there is a lack of scrutiny on certain critical aspects of PCF.
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喉切除术后咽皮瘘:荟萃分析中发现咽皮瘘的综述
目的:本研究的目的是系统地评估meta分析,以确定喉切除术后PCF的文献空白。方法:对PubMed数据库中喉癌全喉切除术后PCF的meta分析进行文献计量学分析。结果:24项荟萃分析被认为符合条件并被选择进行分析。6项荟萃分析(25%)关注TL中PCF的危险因素,4项荟萃分析(16.6%)关注贴壁皮瓣的作用。4项荟萃分析(16.6%)关注于起始喂养的时间。三项荟萃分析(12.5%)集中于使用吻合器进行咽闭合。两项荟萃分析集中于咽重建的类型。其他meta分析分析了唾液旁路管的使用、咽闭合方法、PCF的器官保存方案、原发性和继发性TEP以及非手术治疗对PCF的影响。结论:尽管发表了大量的荟萃分析,但缺乏对PCF某些关键方面的审查。
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