Our Summary

This research paper is about the risk factors associated with developing a pharyngocutaneous fistula (PCF), which is a common complication after throat surgery (total laryngectomy). The research involved looking at a wide range of potential risk factors, including age, gender, smoking and drinking habits, other health conditions, prior treatments, and various factors related to the surgery itself. From the 311 studies they examined, they found that certain factors did increase the risk of developing this complication. These included having chronic obstructive pulmonary disease (COPD), having low hemoglobin levels or needing a blood transfusion, having had radiotherapy or chemoradiotherapy, having advanced tumors, having tumors in specific locations, having remaining cancerous tissue after surgery, and having a neck dissection as part of the surgery.

FAQs

  1. What are the risk factors associated with developing a pharyngocutaneous fistula (PCF) after throat surgery?
  2. How does having chronic obstructive pulmonary disease (COPD) or low hemoglobin levels affect the risk of developing a PCF?
  3. Does the location of the tumor or having remaining cancerous tissue after surgery increase the risk of a pharyngocutaneous fistula?

Doctor’s Tip

One helpful tip a doctor might tell a patient about laryngectomy is to follow a strict post-operative care plan to reduce the risk of developing complications such as a pharyngocutaneous fistula. This may include keeping the surgical site clean and dry, avoiding smoking and alcohol consumption, maintaining good nutrition to support healing, and following up with regular medical appointments to monitor for any signs of infection or other issues. It is also important for the patient to communicate any concerns or symptoms to their healthcare provider promptly.

Suitable For

Based on this research, patients who may be at higher risk of developing a pharyngocutaneous fistula after laryngectomy include those with COPD, low hemoglobin levels, a history of radiotherapy or chemoradiotherapy, advanced tumors, remaining cancerous tissue after surgery, and those who require a neck dissection. Additionally, patients who are older, have a history of heavy smoking and drinking, or have other underlying health conditions may also be at increased risk. It is important for healthcare providers to carefully assess each individual patient’s risk factors before recommending laryngectomy surgery to ensure the best possible outcome and minimize the risk of complications.

Timeline

Before laryngectomy:

  1. Patient is diagnosed with laryngeal cancer and undergoes various tests and consultations with healthcare professionals.
  2. Patient may undergo chemotherapy and/or radiation therapy as part of their treatment plan.
  3. Patient undergoes laryngectomy surgery to remove the larynx and surrounding tissue.
  4. Patient may experience difficulty breathing, swallowing, and speaking post-surgery.

After laryngectomy:

  1. Patient may require a tracheostomy tube to help with breathing.
  2. Patient undergoes speech therapy to learn alternative methods of communication, such as using a voice prosthesis or electrolarynx.
  3. Patient may experience changes in taste, smell, and saliva production.
  4. Patient may need to adjust their diet and feeding methods, such as using a feeding tube.
  5. Patient may experience emotional and psychological challenges related to losing their voice and adjusting to life after surgery.

Overall, the timeline for a patient before and after laryngectomy involves a combination of medical procedures, therapy, and lifestyle adjustments to help the patient adapt to their new way of life.

What to Ask Your Doctor

  1. What is a pharyngocutaneous fistula (PCF) and how common is it after laryngectomy surgery?
  2. What are the risk factors associated with developing a PCF after laryngectomy surgery?
  3. How can I reduce my risk of developing a PCF after laryngectomy surgery?
  4. Are there any specific precautions or steps I should take before and after surgery to prevent PCF?
  5. How will my current health conditions, such as COPD, affect my risk of developing a PCF?
  6. Will the location or stage of my tumor impact my risk of developing a PCF?
  7. How will prior treatments, such as radiotherapy or chemoradiotherapy, impact my risk of developing a PCF?
  8. What is the likelihood of needing a blood transfusion during or after laryngectomy surgery, and how does this affect my risk of developing a PCF?
  9. What is the role of neck dissection in laryngectomy surgery and how does it impact the risk of developing a PCF?
  10. Are there any specific signs or symptoms I should watch for after surgery that may indicate the development of a PCF?

Reference

Authors: Dedivitis RA, Aires FT, Cernea CR, Brandão LG. Journal: Head Neck. 2015 Nov;37(11):1691-7. doi: 10.1002/hed.23804. Epub 2015 Jun 26. PMID: 24958209