Effect of postoperative use of diclofenac on pharyngocutaneous fistula development after primary total laryngopharyngectomy: Results of a single‐center retrospective study. (15th December 2015)

• Record Type: Journal Article
• Authors: Parzefall, Thomas; Wolf, Axel; Czeiger, Shelly; Frei, Klemens; Formanek, Michael; Erovic, Boban M.
• Is Part Of: Head & neck. Volume 38(2016)Supplement 1
• Page Start: E1515
• Page End: E1520
• Publication Date: 2015-12-15
• Subjects: primary laryngectomy -- laryngopharyngectomy -- pharyngocutaneous fistula -- nonsteroidal anti‐inflammatory drug (NSAID) -- diclofenac; Head -- Diseases -- Periodicals; Neck -- Diseases -- Periodicals; Head -- Periodicals; Neck -- Periodicals; Face -- Periodicals; 617.51059
• DOI: 10.1002/hed.24271
• Languages: English
• ISSNs: 1043-3074

Abstract

Abstract: Background: Primary total laryngopharyngectomy is the treatment of choice in many cases of locally advanced hypopharyngeal and laryngeal cancer. Development of pharyngocutaneous fistulae is the most common postoperative complication. A recent Danish study showed significantly increased rates of anastomosal leakage after colorectal resection in patients receiving diclofenac treatment. Methods: We retrospectively analyzed 67 patients after primary total laryngopharyngectomy to determine whether diclofenac increases the risk for development of pharyngocutaneous fistula analogously to leakage in the colorectal area. Results: The fistula rate in the total study population ( n = 67) was 19.4%. In the group receiving diclofenac postoperatively ( n = 31), the fistula rate was 25.8%. In the patient group not receiving diclofenac ( n = 36), the fistula rate was 13.9% ( p = .219). Conclusion: Our results suggest that cyclooxygenase‐2 (COX‐2) selective nonsteroidal anti‐inflammatory drugs (NSAIDs) should be administered with caution after laryngopharyngectomy. Additional studies on larger cohorts are required to further evaluate our findings. © 2015 Wiley Periodicals, Inc. Head Neck 38 : E1515–E1520, 2016