The use of Montgomery salivary bypass tubes and pharyngocutaneous fistula following salvage laryngectomy

C. Shires, Mackenzie Latour, M. Sebelik, Karuna Dewan
{"title":"The use of Montgomery salivary bypass tubes and pharyngocutaneous fistula following salvage laryngectomy","authors":"C. Shires, Mackenzie Latour, M. Sebelik, Karuna Dewan","doi":"10.1002/wjo2.155","DOIUrl":null,"url":null,"abstract":"Pharyngocutaneous fistula (PCF) is the most common complication to follow total laryngectomy (TL) and is associated with increases in length of hospital stay and with a need for revision surgery or readmission, as well as with delays in return to oral diet. Patients who require salvage TL (STL) or primary (chemo)radiation therapy are at higher risk for developing PCF. Due to the quality‐of‐life burden of PCF on patients, limiting this occurrence is crucial.We conducted a retrospective cohort study of patients undergoing STL with placement of Montgomery salivary bypass tube (MSBT)™ for at least 2 weeks duration between 2013 and 2017 at a single institution. Our patients all underwent free flap reconstruction. Our primary outcome of interest was development of PCF. Secondary outcomes included demographics, previous treatment, base of tongue (BOT) involvement, extent of defect, concurrent neck dissection (ND), and margin status. Univariate χ2 analysis was used to evaluate factors associated with PCF.Forty‐four patients underwent STL with Montgomery tube placement and free flap reconstruction. Eight developed PCF (18.2%). The average age was 61.6 years; 36 patients were male (81.8%), whereas eight patients were female (18.2%). There was no association between PCF and previous chemoradiation versus radiation (15.8% vs. 33.3%, P < 0.30), BOT involvement versus not (11.1 vs. 22.2%, P < 0.38), circumferential versus partial defect (18.8% vs. 17.9%, P < 0.94), ND versus none (10% vs. 25%, P < 0.20), or margin status.PCF complicated 18.2% of STL cases at our institution and was not associated with differences in primary treatment modality, presence of concomitant ND, extent of pharyngeal defect, BOT involvement, or positive frozen or permanent surgical margin.","PeriodicalId":510563,"journal":{"name":"World Journal of Otorhinolaryngology - Head and Neck Surgery","volume":"87 17","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2024-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"World Journal of Otorhinolaryngology - Head and Neck Surgery","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1002/wjo2.155","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0

Abstract

Pharyngocutaneous fistula (PCF) is the most common complication to follow total laryngectomy (TL) and is associated with increases in length of hospital stay and with a need for revision surgery or readmission, as well as with delays in return to oral diet. Patients who require salvage TL (STL) or primary (chemo)radiation therapy are at higher risk for developing PCF. Due to the quality‐of‐life burden of PCF on patients, limiting this occurrence is crucial.We conducted a retrospective cohort study of patients undergoing STL with placement of Montgomery salivary bypass tube (MSBT)™ for at least 2 weeks duration between 2013 and 2017 at a single institution. Our patients all underwent free flap reconstruction. Our primary outcome of interest was development of PCF. Secondary outcomes included demographics, previous treatment, base of tongue (BOT) involvement, extent of defect, concurrent neck dissection (ND), and margin status. Univariate χ2 analysis was used to evaluate factors associated with PCF.Forty‐four patients underwent STL with Montgomery tube placement and free flap reconstruction. Eight developed PCF (18.2%). The average age was 61.6 years; 36 patients were male (81.8%), whereas eight patients were female (18.2%). There was no association between PCF and previous chemoradiation versus radiation (15.8% vs. 33.3%, P < 0.30), BOT involvement versus not (11.1 vs. 22.2%, P < 0.38), circumferential versus partial defect (18.8% vs. 17.9%, P < 0.94), ND versus none (10% vs. 25%, P < 0.20), or margin status.PCF complicated 18.2% of STL cases at our institution and was not associated with differences in primary treatment modality, presence of concomitant ND, extent of pharyngeal defect, BOT involvement, or positive frozen or permanent surgical margin.
查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
喉切除术后使用蒙哥马利涎旁路管和咽峡瘘管的抢救方法
咽瘘(PCF)是全喉切除术(TL)后最常见的并发症,与住院时间延长、需要再次手术或再次入院以及延迟恢复口服饮食有关。需要进行抢救性全喉切除术(STL)或初次(化疗)放疗的患者患 PCF 的风险更高。我们对 2013 年至 2017 年期间在一家机构接受 STL 并置入蒙哥马利唾液旁路管 (MSBT)™ 至少 2 周的患者进行了回顾性队列研究。我们的患者均接受了游离皮瓣重建术。我们关注的主要结果是 PCF 的发展。次要结果包括人口统计学、既往治疗情况、舌根部(BOT)受累情况、缺损范围、同时进行的颈部切除术(ND)和边缘状态。44名患者接受了蒙哥马利管置入和游离皮瓣重建的STL手术。44名患者接受了STL与蒙哥马利管置入术和游离皮瓣重建术,其中8人出现了PCF(18.2%)。平均年龄为 61.6 岁;36 名患者为男性(81.8%),8 名患者为女性(18.2%)。PCF与既往化疗与放疗(15.8% vs. 33.3%,P < 0.30)、BOT受累与未受累(11.1% vs. 22.2%,P < 0.38)、环状缺损与部分缺损(18.8% vs. 17.9%,P < 0.94)、ND与无ND(10% vs. 25%,P < 0.20)均无关联。在我院,18.2% 的 STL 病例并发 PCF,且与主要治疗方式、是否伴有 ND、咽部缺损程度、BOT 受累、冰冻或永久性手术切缘阳性等方面的差异无关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 去求助
来源期刊
自引率
0.00%
发文量
0
期刊最新文献
Using a customizable L stent for laryngotracheal stenosis: Patterns of success and failure Indocyanine green fluorescence‐guided sentinel lymph node biopsy: A systematic review Diagnostic value of fasting hypopharyngeal salivary pepsin concentration test for laryngopharyngeal reflux disease Pituitary apoplexy is associated with concurrent or subsequent diagnosis of human immunodeficiency virus Development and validity of type II sulcus vocalis in excised canine larynx
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1