Pharyngocutaneous fistula as a complication of total laryngectomy: Review of the literature and analysis of case records

Pharyngocutaneous fistula is the most common complication of total laryngec tomy. The management of this problem increases hospitalization time and del ays initiation of postoperative radiotherapy, where indicated. To identify factors predisposing to the development of pharyngocutaneous fistula, we re viewed the postoperative courses of 293 patients who underwent total laryng ectomy at our clinic, General factors taken into account were concurrent di seases such as diabetes, liver diseases, or chronic anemia; local factors i ncluded radiotherapy before and after surgery, preoperative tracheostomy, t ype of cervical lymph node removal, and method of pharyngeal closure. We th en compared our data with those reported in the literature by other authors . Last, we applied the Fisher exact test to a correlation we found between the higher incidence of fistula in patients with diabetes, liver diseases, or anemia. The local factor that turned out to be statistically most signif icant for the development of fistula was preoperative radiotherapy.