| 摘要: |
| 目的 探讨下咽癌全喉切除术后咽瘘发生的危险因素。方法 回顾性分析2009年1月至2019年12月南京医科大学附属肿瘤医院收治的89例下咽癌全喉切除患者的临床资料。根据术后是否发生咽瘘分为咽瘘组和无咽瘘组，分析患者相关、疾病相关及治疗相关的咽瘘发生的危险因素。结果 89例患者中有20例术后出现咽瘘，69例未出现咽瘘，总体咽瘘发生率为22.5%。单因素分析显示，咽瘘组有糖尿病史（P=0.031）、术前行放化疗（P=0.021）、术前低白蛋白血症（P=0.008）、术后低白蛋白血症（P=0.002）及采用皮瓣修复（P=0.034）的患者占比高于无咽瘘组。多因素logistic回归分析显示，术后白蛋白水平是咽瘘发生的独立保护因素（OR=0.174，95% CI 0.048～0.626，P=0.007）。结论 有糖尿病、围手术期低白蛋白血症或术前接受放化疗的下咽癌患者全喉切除术后更易发生咽瘘。 |
| 关键词: 下咽癌 全喉切除术 咽瘘 危险因素 |
| DOI：10.16781/j.CN31-2187/R.20220514 |
| 投稿时间：2022-06-17修订日期：2023-04-25 |
| 基金项目:国家自然科学基金青年科学基金（81902725）. |
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| Risk factors of pharyngocutaneous fistula after total laryngectomy for hypopharyngeal carcinoma |
| YAO Weiping,QIAN Yichun,CHEN Wei,ZHANG Yuan* |
(Department of Head and Neck Surgery, The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing 210009, Jiangsu, China
*Corresponding author) |
| Abstract: |
| Objective To investigate the risk factors of pharyngocutaneous fistula (PCF) after total laryngectomy for hypopharyngeal cancer. Methods The clinical data of 89 hypopharyngeal cancer patients, who underwent total laryngectomy in The Affiliated Cancer Hospital of Nanjing Medical University from Jan.2009 to Dec.2019, were retrospectively analyzed.The patients were divided into PCF group and non-PCF group.The risk factors of PCF related to patient, disease, and treatment were analyzed. Results Among the 89 patients, 20 cases had postoperative PCF and 69 had no PCF.The overall incidence of PCF was 22.5%.Univariate analysis showed that the proportions of patients with diabetes mellitus (P=0.031), preoperative chemoradiotherapy (P=0.021), preoperative hypoalbuminemia (P=0.008), postoperative hypoalbuminemia (P=0.002), and flap repair (P=0.034) in the PCF group were significantly higher than those in the non-PCF group.Multivariate logistic regression analysis showed that postoperative albumin level was an independent protective factor for PCF (odds ratio=0.174, 95% confidence interval 0.048-0.626, P=0.007). Conclusion The hypopharyngeal cancer patients with diabetes mellitus, perioperative hypoalbuminemia, or preoperative chemoradiotherapy are more likely to develop PCF after total larynegctomy. |
| Key words: hypopharyngeal carcinoma total laryngectomy pharyngeal fistula risk factors |
