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首页> 外文期刊>Otolaryngology--head and neck surgery: official journal of American Academy of Otolaryngology-Head and Neck Surgery >Salvage laryngectomy after primary radiotherapy: what are prognostic factors for the development of pharyngocutaneous fistulae?
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Salvage laryngectomy after primary radiotherapy: what are prognostic factors for the development of pharyngocutaneous fistulae?

机译：初次放疗后抢救喉切除术：咽喉皮肤瘘的发展的预后因素是什么？

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摘要

In this evidence based case report we addressed the clinical question: which factors predict the occurrence of a pharyngocutaneous fistula after total laryngectomy in patients that already were treated with radiotherapy for a squamous cell carcinoma of the larynx? We searched for relevant synonyms for the domain, being patients earlier treated with radiotherapy for a squamous cell carcinoma of the larynx and having a recurrence for which a salvage total laryngectomy is necessary, with the outcome being the development of a post-operative pharyngocutaneous fistula. We searched for relevant publications in Embase, Pubmed and Web of Science using search terms in title and abstract fields. The search yielded 1764 records, of which three were relevant and valid for our clinical question. Our results show that the absolute risk of a pharyngocutaneous fistula after total laryngectomy in patients earlier treated with radiotherapy for a squamous cell carcinoma of the larynx mainly depends on characteristics and site of the primary tumor. In patients who have a primary glottic laryngeal T1 or T2 tumor the absolute risk of developing a fistula is 11% (95% CI 6; 15%), whereas the risk of developing a fistula in patients with a T3 or T4 extra laryngeal tumor is 35% (95% CI 25; 46%). Other patient and surgical characteristics can however not be ruled out as important prognostic factors since many of them have to date not been studied, e.g. diabetes mellitus, alcohol consumption, smoking, suture materials and surgical technique used.
机译：在这个基于证据的病例报告中，我们解决了临床问题：在已经接受了喉鳞状细胞癌放疗的患者中，哪些因素可预示全喉切除术后咽喉瘘的发生？我们搜索该域的相关同义词，这些患者是较早接受放射治疗的鳞状细胞癌喉癌患者，并且复发需要进行全喉切除术，其结果是术后咽部皮肤瘘的形成。我们使用标题和摘要字段中的搜索词搜索了Embase，Pubmed和Web of Science中的相关出版物。搜索产生了1764笔记录，其中三笔与我们的临床问题相关且有效。我们的研究结果表明，在接受喉癌鳞状细胞癌放疗的早期喉癌患者中，全喉切除后咽部皮肤瘘的绝对风险主要取决于原发肿瘤的特征和部位。在患有原发性声门喉T1或T2肿瘤的患者中，发生瘘管的绝对风险为11％（95％CI 6; 15％），而在患有T3或T4喉外肿瘤的患者中发生瘘管的风险为35％（95％CI 25; 46％）。然而，不能排除其他患者和手术特征作为重要的预后因素，因为至今尚未研究其中许多因素。糖尿病，饮酒，吸烟，缝合材料和手术技术。

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