The effect of salivary bypass tube use on the prevention of pharyngo-cutaneous fistulas after total laryngectomy.

Abstract

INTRODUCTION:

The aim of this retrospective study was to assess the efficacy of Salivary Bypass Tube (SBT) for preventing pharyngo-cutaneous fistula (PCF) in a recent cohort of patients who underwent primary and salvage total laryngectomy (TL).

METHODS:

A consecutive series of 133 patients who underwent total laryngectomy between 1997 and 2019 was reviewed. The incidence of PCF was compared between patients who did not receive SBT (nSBT group; n = 55) and those preventively receiving SBT (SBT group; n = 78) in both primary and salvage TL. Risk factors for PCF were evaluated in a univariate and multivariate analyses.

RESULTS:

The overall PCF rate was 30%. Preoperative characteristics were similar between the nSBT and SBT groups, except for older age (p = 0.016), lower preoperative hemoglobin (p = 0.043), and lesser neoadjuvant chemotherapy (p = 0.015) in the SBT group. The rate of PCF the nSBT group, was 41.5%, compared to 21.8% in the SBT group (p = 0.020). In multivariate analysis, only the use of SBT was associated with lower risk of PCF (OR = 0.41 (95% CI 0.19-0.89), p = 0.026). This effect was verified only in the subgroup of patient operated for salvage TL (OR = 0.225; 95% CI 0.09-0.7; p = 0.008).

CONCLUSION:

The use of SBT in our series in salvage TL, appears to be associated with a decreased risk of PCF.

• Authors: Ali Bohlok, Theo Richet, Marie Quiriny, Esther Willemse, Cécile Dekeyser, Guy Andry, Vincent Donckier, Antoine Digonnet
• Journal: European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery (Eur Arch Otorhinolaryngol) Vol. 279 Issue 1 Pg. 311-317 (Jan 2022) ISSN: 1434-4726 [Electronic] Germany
• PMID: 34554309 (Publication Type: Journal Article)
• Copyright: © 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

Topics

• Aged
• Cutaneous Fistula (epidemiology, etiology, prevention & control)
• Humans
• Laryngeal Neoplasms (surgery)
• Laryngectomy
• Pharyngeal Diseases (epidemiology, etiology, prevention & control)
• Postoperative Complications (epidemiology, etiology, prevention & control)
• Retrospective Studies