フクナガ　ユタカ   Yutaka Fukunaga   福永　豊    所属   川崎医科大学  医学部 臨床医学　形成外科学    職種   講師
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Surgical Outcome of Pharyngocutaneous Fistula After Total Laryngectomy: A Retrospective Study.
掲載誌名	正式名：Annals of plastic surgery 略　 称：Ann Plast Surg ISSNコード：15363708/01487043
掲載区分	国外
巻・号・頁	87(4),pp.431-434
著者・共著者	Takuya Higashino, Azusa Oshima, Yutaka Fukunaga, Ryuichi Hayashi
発行年月	2021/10
概要	BACKGROUND:The management of pharyngocutaneous fistula is challenging. We typically treat postlaryngectomy pharyngocutaneous fistulas with a pedicled pectoralis major flap transfer. This study analyzed the outcomes of our surgical treatments for pharyngocutaneous fistula to propose considerations for surgical strategies.METHODS:This retrospective review included all patients who underwent surgical repair of a postlaryngectomy pharyngocutaneous fistula at the National Cancer Center Hospital East in Kashiwa, Japan, from January 2005 to December 2019.RESULTS:The final analysis included 33 cases (median age, 71 years). Twenty-two cases had a history of radiotherapy to the head and neck region. Wound closures were performed with a pedicled pectoralis major musculocutaneous flap (n = 26) or pedicled pectoralis major muscle flap (n = 7). In 1 case, a deltopectoral flap was combined with the pectoralis major musculocutaneous flap. The median total operation time was 236 minutes, the median blood loss during surgery was 144 mL, and the median hospital stay after the reconstructive surgery was 39 days. Minor leakage occurred in 19 cases, and major leakage occurred in 2 cases. The fistula was finally cured successfully in 31 cases. We compared the outcomes in patients with leakage after surgical repair to those in patients without leakage after surgical repair to determine the risk factors for leakage after surgical repair of a pharyngocutaneous fistula. Five patients in the nonleakage group and 17 in the leakage group had a history of preoperative radiation (P = 0.052). The median preoperative blood values in the nonleakage and leakage groups were as follows: albumin, 3.6 and 3.2 g/dL (P = 0.061), and C-reactive protein, 2.36 and 6.77 mg/dL (P = 0.031), respectively. The time between the occurrence of the fistula and reconstructive surgery was 32 and 9 days in the nonleakage and leakage groups, respectively (P = 0.009).CONCLUSIONS:Our surgical treatment for postlaryngectomy p
DOI	10.1097/SAP.0000000000002769
PMID	33661211