Pharyngocutaneous fistula following total laryngectomy and identification of etiological factors

The aim of this study was to establish the incidence and the risk factors of pharyngocutaneous fistula after total laryngectomy. We study 59 patients who underwent total laryngectomy because the malignant neoplasm of the larynx at Akdeniz University Faculty of Medicine Otolaryngology Department between the 2014 to 2021. Patient datas were recorded at patient files and Akdeniz University Faculty of Medicine Hospital database retrospectively. In this study; we determined which patient were underwent total laryngectomy , examined preoperative and postoperative clinical follow-ups to investigate devolopment of pharyngocutaneus fistula and presence of risk factors that might cause it. Patients demographic datas like; age, gender with patological diagnosis, tumor stages, the history of previos chemotherapy and radiotherapy , devolopment of pharyngocutaneus fistula after surgery, presence of reconstruction with myocutaneus flap, preoperative and postoperative hemoglobin values, postoperative albumin values, comorbid disease like diabetes mellitus, hipertension and coronery artery disease and tumor site will be investigated in this study. Statistical analysis was done with SPSS program. A p value < 0.05 was considered statistically significant. In our study we included 59 patients who underwent total laryngectomy. The incidance of pharyngocutaneous fistula detected as %23.7 (n=14). Devolopment of pharyngocutenous fistula was reletad between only nodal stages of patients inside of the all parameters (p=0.032). This study indicated; T stage of tumor, previos radiotheraphy, presence of salvage surgery, postoperative albumin values, preoperative- postoperative hemoglobin values, comorbid diseases, presence of reconstruction with myocutaneus flap, tumor site, age , gender were not related with devolopment of pharyngocutenous fistula (p>0.05). At the present, risk factors of pharyngocutaneous fistula are still controversial and many studies will be necessary to find the most important risk factor. Devolopment of pharyngocutenous fistula was reletad between only nodal stages of patients. Factors like; low number of patients, diffuculty of to reach some patient datas (like history of smoking…) could not be achive similar results of some literatures. In summary; pharyngocutenous fistula after total laryngectomy is the result of multiple factors. A comprehensive preoperative understanding of the risk factors of pharyngocutaneous fistula may reduce the likelihood of developing PCF in high-risk patients. Key Words: Total laryngectomy, larynx carcinoma, pharyngocutaneus fistula, risk factors, salvage total laryngectomy, postoperative complications