Risk factors for postoperative pharyngocutaneous fistula after total laryngectomy

Purpose The aim of the present study was to retrospectively analyze the most relevant factors and conditions associated with the development of postoperative pharyngocutaneous fistula (PCF). Methods The present study retrospectively reviewed the clinical charts of a cohort of 95 patients who underwent TL at our Institution. The predictive value of demographic, clinical and surgical parameters in terms of postoperative PCF development were evaluated through univariate analysis. Results Stronger predictive factors for developement of post-laryngectomy PCF were (i) preoperative Albumin levels < 3.5 g/dL, (ii) preoperative Hb < 12.5 g/L; (iii) preoperative BMI < 18.5; (iv) Previous treatments, and in particular RT; (v) longer surgical time. On the other hand, primary TEP was not found to be related to higher PCF rates. Conclusions A preoperative comprehensive assessment of the patient’s overall nutritional status and improvement of the perioperative nutritional support should be always carried out in order to reduce the incidence of postoperative PCF.