Pharyngocutaneous fistulae in laryngectomy patients: the Toronto Hospital experience

Abstract

Objective: The purpose of this study was to determine the rate of post-laryngectomy pharyngocutaneous fistulae and its association with age, gender, preoperative radiation, TNM staging, patients comorbidity factors, choice of ablation, choice of reconstruction, modality of postoperative feeding, and whether or not a primary tracheoesophageal puncture was performed.

Design: Retrospective clinical study.

Setting: The Toronto Hospital/Princess Margaret Hospital, University of Toronto, Toronto, Ontario.

Method: One hundred and twenty-five consecutive laryngectomy procedures performed between July 1, 1992, and October 1, 1996, were reviewed.

Results: There was an overall fistula rate of 22%. No association found was between fistula rates and age, gender, patient comorbidity factors, TNM stage, choice of ablation, choice of reconstruction, modality of postoperative feeding, or whether a primary tracheoesophageal puncture was performed or not.

Conclusions: At this tertiary care head and neck oncology centre, pharyngocutaneous fistulae remain an unpredictable and serious complication with an estimated economic cost of Cdn $400,000 per year.