Background:This study aimed to analyse the variability in the incidence of the pharyngocutaneous fistula (PCF), the most common complication following a total laryngectomy (TLE), and to identify the underlying causes for fluctuations in incidence rates.Methods:In the retrospective study, the annual PCF incidence data and comprehensive clinicopathologic data from 540 patients who underwent TLE between January 2004 and December 2022 were reviewed. Distinct peri ods of both high and low PCF incidence were identified. Within these periods, patients were categorized into groups with PCF (study groups) and without it (control groups). These groups were statistically compared based on potential risk factors for PCF development. The high-incidence periods were specially analysed for recurring risk factors and the corresponding corrective measures were reviewed.Results:The analysis revealed four high-incidence periods with an overall PCF incidence of 37.61%, along with three low-incidence periods in between with an overall incidence of 19.38%. Surgical wound infection (SWI) and a history of head and neck cancer alongside their related treatments were repeatedly identified as independent risk factors during high-incidence periods, with SWI being the most consistent predictor of PCF development.Conclusions:Continuous monitoring of PCF incidence is crucial, as it allows for the identification of emerging risk factors and the immediate implementation of corrective measures to mitigate these newly identified risk factors.
背景：本研究旨在分析全喉切除术后最常见并发症——咽皮瘘发生率的波动情况，并探究其发生率变化的潜在原因。方法：本回顾性研究分析了2004年1月至2022年12月期间接受全喉切除术的540例患者的年度咽皮瘘发生率数据及完整临床病理资料。研究识别出咽皮瘘高发期与低发期，在各时期将患者分为咽皮瘘组（研究组）与非咽皮瘘组（对照组），基于已知潜在风险因素进行统计学比较。特别针对高发期反复出现的风险因素进行分析，并评估相应纠正措施的实施效果。结果：分析显示存在四个咽皮瘘高发期（总体发生率37.61%）及三个低发期（总体发生率19.38%）。手术切口感染及头颈部肿瘤病史与相关治疗史在高发期被反复确认为独立风险因素，其中手术切口感染是预测咽皮瘘发生最稳定的指标。结论：持续监测咽皮瘘发生率至关重要，这有助于及时发现新的风险因素，并立即实施针对性纠正措施以降低新发现风险因素的影响。
肿瘤(癌症)患者之家