Results of Platelet-Rich Fibrin Application in Pharyngeal Reconstruction After a Total Laryngectomy

IF 1.7 4区医学 Q2 OTORHINOLARYNGOLOGY Clinical Otolaryngology Pub Date : 2024-10-19 DOI:10.1111/coa.14247

Ayça Başkadem Yilmazer, Elif Aksungur, Cem Çelik, Avni Akin Bayram, Hüseyin Turgut, Mehmet Emre Dinç, Ayşe Enise Göker, Yavuz Uyar

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Abstract

Introduction

Pharyngocutaneous fistula (PCF) is one of the most challenging complications observed after a total laryngectomy. Since the biochemical components of platelet-rich fibrin (PRF) have well-known synergistic effects on the healing processes, this study aimed to demonstrate the contribution of PRF application to pharyngeal healing in patients undergoing a total laryngectomy for laryngeal cancer.

Methods

The study compared patients who underwent a total laryngectomy due to laryngeal squamous cell carcinoma and had a PRF membrane placed during the pharyngoesophageal closure with those who did not. There were two groups: PRF-positive and PRF-negative. In the PRF-positive group, after the completion of the total laryngectomy and moving on to the pharyngoesophageal closure stage, along the suture line, PRF material is laid in two pieces in a T-shape and secured with several sutures. No PRF application was done in the PRF-negative group. Pharyngeal healing steps (nasogastric feeding, oral feeding, development of a fistula), haemoglobin and albumin values, tumour involvement areas, time to oral intake and length of hospital stay were recorded for all patients.

Results

This study reviewed the records of 33 patients who underwent pharyngoesophageal closure with PRF application after a total laryngectomy (PRF-positive group) and 35 patients without PRF application (PRF-negative group). When comparing patients in terms of developing a PCF, 6% (n = 2) of patients in the PRF-positive group and 25.7% (n = 9) in the PRF-negative group developed a fistula. This ratio was significantly higher in the PRF-negative group (p = 0.027).

Conclusion

The application of PRF in pharyngoesophageal reconstruction after a total laryngectomy may strengthen wound healing and reduce the risk of PCF development.

Trial Registration

This study is a retrospective designed study; therefore, there is no clinical trial registration

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全喉切除术后应用富血小板纤维蛋白进行咽部重建的结果

简介：咽瘘（PCF）是全喉切除术后最棘手的并发症之一。由于富血小板纤维蛋白（PRF）中的生化成分对愈合过程具有众所周知的协同作用，本研究旨在证明富血小板纤维蛋白的应用对喉癌全喉切除术患者咽部愈合的贡献：该研究比较了因喉鳞状细胞癌接受全喉切除术并在咽喉食管闭合过程中植入 PRF 膜的患者和未植入 PRF 膜的患者。分为两组：PRF阳性组和PRF阴性组。在 PRF 阳性组中，在完成全喉切除术并进入咽喉食管闭合阶段后，沿缝合线将 PRF 材料分两块铺成 T 形，并用数针缝合固定。PRF 阴性组不使用 PRF。所有患者的咽部愈合步骤（鼻饲、口服、瘘管形成）、血红蛋白和白蛋白值、肿瘤受累面积、口服时间和住院时间均有记录：本研究回顾了33例在全喉切除术后应用PRF进行咽食管闭合的患者（PRF阳性组）和35例未应用PRF的患者（PRF阴性组）的病历。在比较患者出现 PCF 的情况时，PRF 阳性组中有 6% 的患者（n = 2）出现了瘘管，而 PRF 阴性组中有 25.7% 的患者（n = 9）出现了瘘管。这一比例在 PRF 阴性组明显更高（P = 0.027）：结论：在全喉切除术后的咽喉食管重建中应用 PRF 可加强伤口愈合，降低 PCF 发生的风险：本研究为回顾性研究，因此未进行临床试验登记。

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来源期刊

Clinical Otolaryngology 医学-耳鼻喉科学

CiteScore

4.00

自引率

4.80%

发文量

106

审稿时长

>12 weeks

期刊介绍： Clinical Otolaryngology is a bimonthly journal devoted to clinically-oriented research papers of the highest scientific standards dealing with: current otorhinolaryngological practice audiology, otology, balance, rhinology, larynx, voice and paediatric ORL head and neck oncology head and neck plastic and reconstructive surgery continuing medical education and ORL training The emphasis is on high quality new work in the clinical field and on fresh, original research. Each issue begins with an editorial expressing the personal opinions of an individual with a particular knowledge of a chosen subject. The main body of each issue is then devoted to original papers carrying important results for those working in the field. In addition, topical review articles are published discussing a particular subject in depth, including not only the opinions of the author but also any controversies surrounding the subject. • Negative/null results In order for research to advance, negative results, which often make a valuable contribution to the field, should be published. However, articles containing negative or null results are frequently not considered for publication or rejected by journals. We welcome papers of this kind, where appropriate and valid power calculations are included that give confidence that a negative result can be relied upon.