Pharyngocutaneous fistula and delay in free oral feeding after pharyngolaryngectomy for hypopharyngeal cancer

Head & Neck
Sayaka SuzukiTatsuya Yamasoba

Abstract

Risk factors for pharyngocutaneous fistula and associated delay in free oral feeding after pharyngolaryngectomy for patients with hypopharyngeal cancer remain uncertain. We used a Japanese national inpatient database to perform a retrospective cohort study between 2007 and 2013. We performed multivariable logistic regression analysis to identify patient characteristics associated with pharyngocutaneous fistula formation, and Cox regression analysis to evaluate factors affecting the interval from pharyngolaryngectomy to free oral feeding. Among 549 eligible patients, 33 had developed pharyngocutaneous fistula, 19 of whom required surgical closure. Preoperative radiotherapy significantly increased risk of pharyngocutaneous fistula (odds ratio [OR] = 3.17; 95% confidence interval [CI] = 1.10-9.12; p = .033). Pharyngocutaneous fistula significantly prolonged the interval to oral feeding (median days, 67 vs 20 in those with and without pharyngocutaneous fistula, respectively; hazard ratio [HR], = 0.26; 95% CI = 0.15-0.44; p < .001). Preoperative radiotherapy was associated with increased occurrence of pharyngocutaneous fistula and subsequent delay in free oral feeding. © 2015 Wiley Periodicals, Inc. Head Neck 38: E-E, 2016.

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Oct 11, 2015·Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons·Naseem GhazaliJoshua E Lubek
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