Levent ERİŞEN, Fikret KASAPOĞLU, Hamdi Hakan COŞKUN, Oğuz BASUT, İlker TEZER, İbrahim HIZALAN, Selçuk ONART
Total larenjektomi sonrası farengokutanöz fistül gelişimini etkileyen faktörler ve fistül tedavisine yaklaşımımız
Amaç: Total larenjektomi TL uygulanan hastalardafarengokutanöz fistül FKF görülme sıklığı ve fistülgeliflimi ile ilgili faktörler arafltırıldı.Hastalar ve Yöntem: Yassı epitel hücreli karsinomnedeniyle 138 hastada TL uygulandı. Farengokutanözfistül oluflumunda rolü olduğu düflünülen faktörler vefistül geliflen olgularda fistülün ortaya çıkıfl, ağızdanbeslenmeye geçifl, hastanede yatıfl ve fistülün kapanma süreleri tedavi yaklaflımı ile birlikte değerlendirildi.Bulgular: Otuz yedi hastada %26.8 FKF saptandı.Alkollü içecek kullanmanın p=0.032 , cerrahiye parsiyel farenjektomi p=0.058 veya iki taraflı boyun diseksiyonu p=0.049 eklenmesinin FKF geliflimindeanlamlı rolü olduğu belirlendi. Ağızdan gıdaya geçiflve hastanede kalıfl süreleri FKF geliflen olgulardaanlamlı derecede yüksekti p
Anahtar Kelimeler:
Kutanöz fistül/etyoloji/tedavi, fistül/etyoloji/tedavi, larenjeal neoplazmlar/cerrahi, larenjektomi/komplikasyon, risk faktörleri
The management of pharyngocutaneous fistulas after total laryngectomy and the factors affecting their incidence
Objectives: This study sought to determine the inci dence and etiologic factors of pharyngocutaneous fistulas occurring after total laryngectomy.Patients and Methods: A total of 138 patients 136 males, 2 females; mean age 59.5 years; range 36 to 83 years underwent total laryngectomy for squamous celi carcinoma. Risk factors and the manage ment of pharyngocutaneous fistulas were assessed together with durations in relation to fistula occurrence, oral feeding, hospitalization, and healing.Results: Pharyngocutaneous fistulas were seen in 37 patients 26.8% . Significantly high rates of fistula occur- rence were detected in patients with alcohol consumption p=0.032 , and in those who undervvent partial pharyn- gectomy p=0.058 or bilateral neck dissection p=0.049 along with total laryngectomy. The occurrence of fistulas was significantly associated with prolonged lengths of time for oral feeding and hospital stay p<0.001 . Fistulas were repaired surgically in 24.3% of patients, in whom the time to oral feeding was significantly shorter than that of patients who received local wound çare p=0.03 .Conclusion: Our data show that early surgical intervention is more beneficial in preventing further morbidity associated with pharyngocutaneous fistulas.
Keywords:
Cutaneous fistula/etiology/therapy, fistula/etiology/therapy, laryngeal neoplasms/surgery, laryngectomy/ complications, risk factors,
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- ISSN: 2602-4837
- Yayın Aralığı: Yılda 4 Sayı
- Başlangıç: 1991
- Yayıncı: İstanbul Üniversitesi
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