방사선 치료 유무 및 수술 범위에 따른 후두전절제술 후 인두피부누공 발생률 분석

Pharyngocutaneous Fistula Formation Rate after Total Laryngectomy, Related with Previous Radiotherapy and Extent of Surgery

Background and Objectives：Pharyngocutaneous fistula is the most common complication after total laryn-gectomy. The objective of this study was to determine the incidence of pharyngocutaneous fistula after total laryn-gectomy in patients operated on in our department and to establish whether specific factors predispose to fistula formation. Materials and Methods：For 10 years(2003-2014), 49 cases of patients who were diagnosed with la-ryngeal cancer and underwent total laryngectomy in our department. Patients who underwent radiotherapy before the surgery was 24 cases(48.9%) of all total laryngectomy patients. And those who were needed flap reconstruc-tion because of extensive tumor involvement to hypopharynx were also 24 cases(48.9%), whereas primary closure were performed in 25 cases(51%). Results：The postoperative pharyngocutaneous fistula was found in 12 of the 49 patients(24.5%). The radiotherapy before surgery was a statistically significant factor that increase the inci-dence of postoperative fistulas(p=0.037). Large extent of surgery including flap reconstruction was almost statisti-cally significant factor of raising postoperative fistula rates(p=0.051). Conclusion：According to this study, the pres-ence of postoperative fistula seems to be influenced by previous radiotherapy and the extent of surgery. These could be the risk factors of pharyngocutaneous fistula after total laryngectomy.