Pharyngocutaneous fistula after total laryngectomy: A systematic review and meta-analysis of risk factors. Issue 5 (October 2015)

• Record Type: Journal Article
• Authors: Liang, Ji-Wang; Li, Zhen-Dong; Li, Shu-Chun; Fang, Feng-Qin; Zhao, Yue-Jiao; Li, Yan-Guo
• Is Part Of: Auris nasus larynx. Volume 42:Issue 5(2015)
• Page Start: 353
• Page End: 359
• Publication Date: 2015-10
• Subjects: Pharyngocutaneous fistula -- Total laryngectomy -- Risk factor -- Meta-analysis; Otolaryngology -- Periodicals; Electronic journals; 616
• DOI: 10.1016/j.anl.2015.04.002
• Languages: English
• ISSNs: 0385-8146

Abstract

Abstract: Objective: The pharyngocutaneous fistula (PCF) is the troublesome complication after total laryngectomy. Despite a large number of investigations having been performed, there is still controversy about which factors are most significant for PCF. The objective of the present meta-analysis was to analyze the potential risk factors for PCF after total laryngectomy. Data sources: Published English-language literature. Review methods: PubMed, Ovid, Cochrane, and Web of Science databases were systematically searched using multiple search terms. Twenty-one studies with 3832 patients were identified. The quality of evidence was assessed by The National Institute for Health and Clinical Excellence. Results: Sixteen studies involving 2598 patients were included for the meta-analysis. The results showed that, tumor subsite (RR = 0.64, 95% CI 0.47–0.88, P < 0.01), T stage (RR = 0.70, 95% CI 0.51–0.96, P = 0.03), previous radiotherapy (RR = 0.62, 95% CI 0.46–0.84, P < 0.01), postoperative hemoglobin <12.5 g/L (RR = 0.46, 95% CI 0.27–0.76, P < 0.01), and surgical margin (RR = 0.41, 95% CI 0.22–0.74, P < 0.01) were the risk factors associated with the development of PCF. Conclusions: From the results of our study, several significant risk factors for PCF are identified. Methodologically high-quality comparative studies are needed for further evaluation.