预防全喉切除术后咽瘘发生的研究进展
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摘要
<正>全喉切除术是我国目前治疗咽喉部恶性肿瘤的常用治疗方法,可以为患者提供很好的治疗效益,但也伴随着一些并发症发生的可能。咽瘘是其中最常见的并发症,发生率高,延长住院时间,影响术后恢复,增加患者心理及家庭经济负担等。近年来非手术的保喉治疗方案的疗效逐渐被肯定,并在国外逐渐流行,我国也有部分早期(T1-2M0N0)患者以及部分中晚期但拒绝全喉切除且肿瘤不能完全切除的患者选择根治性放疗或放化疗。但保喉治疗后如果肿瘤残存或者复发,则需考虑行挽救性
Total laryngectomy is a common method for the treatment of malignant tumors of the pharynx and larynx in China,but pharyngocutaneous fistula often happens after surgery,which burdens patients and affects postoperative recovery.At present,there are many measures to prevent pharyngocutaneous fistula,including strengthening nutrition pre-operative and post-operative,testing related indicators,controlling comorbidities,rational use of drugs,regular oral care,optimal selection of incision closure,and using of flaps and special materials during operation,etc.However,the choice of specific program needs to take care of the patient's condition,surgeon's skills and hospital conditions,and often requires multiple programs to be used together throughout the perioperative period.This article will provide a brief review of some strategies for preventing pharyngocutaneous fistula after total laryngectomy.
Total laryngectomy is a common method for the treatment of malignant tumors of the pharynx and larynx in China,but pharyngocutaneous fistula often happens after surgery,which burdens patients and affects postoperative recovery.At present,there are many measures to prevent pharyngocutaneous fistula,including strengthening nutrition pre-operative and post-operative,testing related indicators,controlling comorbidities,rational use of drugs,regular oral care,optimal selection of incision closure,and using of flaps and special materials during operation,etc.However,the choice of specific program needs to take care of the patient's condition,surgeon's skills and hospital conditions,and often requires multiple programs to be used together throughout the perioperative period.This article will provide a brief review of some strategies for preventing pharyngocutaneous fistula after total laryngectomy.
引文
[1]SIFRER R,ANICIN A,POHAR M P,et al.Pharyngocutaneous fistula:the incidence and the risk factors[J].Eur Arch Otorhinolaryngol,2016,273:3393-3399.
[2]熊亚军,金日群,刘芳,等.全喉切除术后咽瘘的治疗现状[J].临床耳鼻咽喉头颈外科杂志,2017,31(23):1858-1862.
[3]STEPHENSON K A,FAGAN J J.Effect of perioperative proton pump inhibitors on the incidence of pharyngocutaneous fistula after total laryngectomy:a prospective randomized controlled trial[J].Head Neck,2015,37:255-259.
[4]LEBO N L,CAULLEY L,ALSAFFAR H,et al.Peri-operative factors predisposing to pharyngocutaneous fistula after total laryngectomy:analysis of a large multi-institutional patient cohort[J].J Otolaryngol Head Neck Surg,2017,46:54-61.
[5]DEDIVITIS R A,AIRES F T,CERNEA C R,et al.Pharyngocutaneous fistula after total laryngectomy:systematic review of risk factors[J].Head Neck,2015,37:1691-1697.
[6]CECATTO S B,SOARES M M,HENRIQUES T,et al.Predictive factors for the postlaryngectomy pharyngocutaneous fistula development:systematic review[J].Braz J Otorhinolaryngol,2014,80:167-177.
[7]黄楠,朱一鸣,安常明,等.喉全切除术后早期经口进食的初步研究[J].中华耳鼻咽喉头颈外科杂志,2018,53(6):428-431.
[8]BENSON E M,HIRATA R M,THOMPSON C B,et al.Pharyngocutaneous fistula after total laryngectomy:a single-institution experience,2001-2012[J].Am J Otolaryngol,2015,36:24-31.
[9]LIANG J W,LI Z D,LI S C,et al.Pharyngocutaneous fistula after total laryngectomy:A systematic review and meta-analysis of risk factors[J].Auris Nasus Larynx,2015,42:353-359.
[10]BUSONI M,DEGANELLO A,GALLO O.Pharyngocutaneous fistula following total laryngectomy:analysis of risk factors,prognosis and treatment modalities[J].Acta Otorhinolaryngol Ital,2015,35:400-405.
[11]PARZEFALL T,WOLF A,CZEIGER S,et al.Effect of postoperative use of diclofenac on pharyngocutaneous fistula development after primary total laryngopharyngectomy:Results of a single-center retrospective study[J].Head Neck,2016,38:E1515-E1520.
[12]VASANI S S,YOUSSEF D,LIN C,et al.Defining the low-risk salvage laryngectomy-A single-center retrospective analysis of pharyngocutaneous fistula[J].Laryngoscope Investig Otolaryngol,2018,3:115-120.
[13]LI R J,ZHOU X C,FAKHRY C,et al.Reduction of Pharyngocutaneous Fistulae in Laryngectomy Patients by a Comprehensive Performance Improvement Intervention[J].Otolaryngol Head Neck Surg,2015,153:927-934.
[14]CANNON R B,HOULTON J J,MENDEZ E,et al.Methods to reduce postoperative surgical site infections after head and neck oncology surgery[J].Lancet Oncol,2017,18:e405-e413.
[15]STATHAS T,MALLIS A,MASTRONIKOLIS NS,et al.Pharyngocutaneous fistula complicating laryngectomy:can metronidazole help[J]?ORL J Otorhinolaryngol Relat Spec,2011,73:291-294.
[16]JOHANSEN L V,OVERGAARD J,ELBROND O.Pharyngo-cutaneous fistulae after laryngectomy.Influence of previous radiotherapy and prophylactic metronidazole[J].Cancer,1988,61:673-678.
[17]高云飞,刘丽然,李明天,等.全喉术中密闭性检测预防术后咽瘘临床意义探讨[J].中华肿瘤防治杂志,2018,25(11):796-798.
[18]王文武,魏小林,苏纪平.线型闭合器在全喉切除术中的应用现状[J].临床耳鼻咽喉头颈外科杂志,2017,31(1):78-81.
[19]WALTON B,VELLUCCI J,PATEL P B,et al.Post-Laryngectomy stricture and pharyngocutaneous fistula:Review of techniques in primary pharyngeal reconstruction in laryngectomy[J].Clin Otolaryngol,2018,43:109-116.
[20]SHAN H,GAO Y,LIU L,et al.Magnifying endoscopy with narrow-band imaging to assist the linear stapler closure of the pharynx during total laryngectomy[J].Am J Otolaryngol,2018,39:511-514.
[21]HAKSEVER M,AKDUMAN D,ASLAN S,et al.Modified Continuous Mucosal Connell Suture for the Pharyngeal Closure After Total Laryngectomy:Zipper Suture[J].Clin Exp Otorhinolaryngol,2015,8:281-288.
[22]DENIZ M,CIFTCI Z,GULTEKIN E.Pharyngoesophageal Suturing Technique May Decrease the Incidence of Pharyngocutaneous Fistula following Total Laryngectomy[J].Surg Res Pract,2015,2015:363640.
[23]SCOTTON W J,NIXON I J,PEZIER T F,et al.Time interval between primary radiotherapy and salvage laryngectomy:apredictor of pharyngocutaneous fistula formation[J].Eur Arch Otorhinolaryngol,2014,271:2277-2283.
[24]SHARAF B,XUE A,SOLARI M G,et al.Optimizing Outcomes in Pharyngoesophageal Reconstruction and Neck Resurfacing:10-Year Experience of 294Cases[J].Plast Reconstr Surg,2017,139:105e-119e.
[25]PATEL U A,MOORE B A,WAX M,et al.Impact of pharyngeal closure technique on fistula after salvage laryngectomy[J].JAMA Otolaryngol Head Neck Surg,2013,139:1156-1162.
[26]PALERI V,DRINNAN M,VAN DEN BREKEL MW,et al.Vascularized tissue to reduce fistula following salvage total laryngectomy:a systematic review[J].Laryngoscope,2014,124:1848-1853.
[27]GENDREAU-LEFEVRE A K,AUDET N,MAL-TAIS S,et al.Prophylactic pectoralis major muscle flap in prevention of pharyngocutaneous fistula in total laryngectomy after radiotherapy[J].Head Neck,2015,37:1233-1238.
[28]GUIMARAES A V,AIRES F T,DEDIVITIS R A,et al.Efficacy of pectoralis major muscle flap for pharyngocutaneous fistula prevention in salvage total laryngectomy:A systematic review[J].Head Neck,2016,38:E2317-E2321.
[29]ANSCHUTZ L,NISA L,ELICIN O,et al.Pectoralis major myofascial interposition flap prevents postoperative pharyngocutaneous fistula in salvage total laryngectomy[J].Eur Arch Otorhinolaryngol,2016,273:3943-3949.
[30]CHIESA E C,GONZALEZ G J,SISTIAGA S J,et al.Efficacy of the myofascial pectoralis major flap in the reduction of salivary fistulas after salvage total laryngectomy[J].Acta Otorrinolaringol Esp,2018,69:99-104.
[31]KHAN N A,MEDINA J E,SANCLEMENT J A,et al.Fistula rates after salvage laryngectomy:comparing pectoralis myofascial and myocutaneous flaps[J].Laryngoscope,2014,124:1615-1617.
[32]SHARMA S,CHAUKAR D A,LASKAR S G,et al.Role of the pectoralis major myofascial flap in preventing pharyngocutaneous fistula following salvage laryngectomy[J].J Laryngol Otol,2016,130:860-864.
[33]SITTITRAI P,SRIVANITCHAPOOM C,REUN-MAKKAEW D.Prevention of pharyngocutaneous fistula in salvage total laryngectomy:role of the pectoralis major flap and peri-operative management[J].JLaryngol Otol,2018,132:246-251.
[34]GILBERT M R,STURM J J,GOODING W E,et al.Pectoralis major myofascial onlay and myocutaneous flaps and pharyngocutaneous fistula in salvage laryngectomy[J].Laryngoscope,2014,124:2680-2686.
[35]POWELL J,ULLAL U R,AHMED O,et al.Tissue transfer to post-chemoradiation salvage laryngectomy defects to prevent pharyngocutaneous fistula:singlecentre experience[J].J Laryngol Otol,2014,128:365-367.
[36]KAO H K,ABDELRAHMAN M,CHANG K P,et al.Choice of flap affects fistula rate after salvage laryngopharyngectomy[J].Sci Rep,2015,5:9180-9184.
[37]KADOTA H,FUKUSHIMA J,KAMIZONO K,et al.A minimally invasive method to prevent postlaryngectomy major pharyngocutaneous fistula using infrahyoid myofascial flap[J].J Plast Reconstr Aesthet Surg,2013,66:906-911.
[38]NAGHIBZADEH M,ZOJAJI R,MOKHTARI A-MIR MAJDI N,et al.Using a sternocleidomastoid muscle flap to prevent postoperative pharyngocutaneous fistula after total laryngectomy:a study of 88cases[J].Ear Nose Throat J,2014,93:362-365.
[39]IBRAHIM S G,WAHBA B M,ELBATAWI A M,et al.Sternocleidomastoid flap augmentation of the pharyngeal closure after total laryngectomy[J].Eur Arch Otorhinolaryngol,2017,274:3197-3202.
[40]AIRES F T,DEDIVITIS R A,PETRAROLHA SM,et al.Early oral feeding after total laryngectomy:A systematic review[J].Head Neck,2015,37:1532-1535.
[41]BONDI S,GIORDANO L,LIMARDO P,et al.Role of Montgomery salivary stent placement during pharyngolaryngectomy,to prevent pharyngocutaneous fistula in high-risk patients[J].J Laryngol Otol,2013,127:54-57.
[42]KAMHIEH Y,FOX H,HALLETT E,et al.Routine use of salivary bypass tubes in laryngectomy patients:systematic review[J].J Laryngol Otol,2018,132:380-384.
[43]HONE R,RAHMAN E,WONG G,et al.Do salivary bypass tubes lower the incidence of pharyngocutaneous fistula following total laryngectomy?A retrospective analysis of predictive factors using multivariate analysis[J].Eur Arch Otorhinolaryngol,2017,274:1983-1991.
[44]ERYILMAZ A,DEMIRCI B,GUNEL C,et al.Can tissue adhesives and platelet-rich plasma prevent pharyngocutaneous fistula formation[J]?Auris Nasus Larynx,2016,43:62-67.
[45]LEE D W,CHUNG S,LEE W J,et al.Use of a collagen patch for management of pharyngocutaneous fistula after hypopharyngeal reconstruction[J].JCraniofac Surg,2010,21:1674-1676.
[46]DEMIR B,SARI M,BINNETOGLU A,et al.Comparison of pharyngocutaneous fistula closure with and without bacterial cellulose in a rat model[J].Auris Nasus Larynx,2018,45:301-305.
[47]TIMMERMANS A J,LANSAAT L,KROON G V,et al.Early oral intake after total laryngectomy does not increase pharyngocutaneous fistulization[J].Eur Arch Otorhinolaryngol,2014,271:353-358.
[48]SUSLU N,SEFIK H A.Early oral feeding after total laryngectomy:Outcome of 602patients in one cancer center[J].Auris Nasus Larynx,2016,43:546-550.
[2]熊亚军,金日群,刘芳,等.全喉切除术后咽瘘的治疗现状[J].临床耳鼻咽喉头颈外科杂志,2017,31(23):1858-1862.
[3]STEPHENSON K A,FAGAN J J.Effect of perioperative proton pump inhibitors on the incidence of pharyngocutaneous fistula after total laryngectomy:a prospective randomized controlled trial[J].Head Neck,2015,37:255-259.
[4]LEBO N L,CAULLEY L,ALSAFFAR H,et al.Peri-operative factors predisposing to pharyngocutaneous fistula after total laryngectomy:analysis of a large multi-institutional patient cohort[J].J Otolaryngol Head Neck Surg,2017,46:54-61.
[5]DEDIVITIS R A,AIRES F T,CERNEA C R,et al.Pharyngocutaneous fistula after total laryngectomy:systematic review of risk factors[J].Head Neck,2015,37:1691-1697.
[6]CECATTO S B,SOARES M M,HENRIQUES T,et al.Predictive factors for the postlaryngectomy pharyngocutaneous fistula development:systematic review[J].Braz J Otorhinolaryngol,2014,80:167-177.
[7]黄楠,朱一鸣,安常明,等.喉全切除术后早期经口进食的初步研究[J].中华耳鼻咽喉头颈外科杂志,2018,53(6):428-431.
[8]BENSON E M,HIRATA R M,THOMPSON C B,et al.Pharyngocutaneous fistula after total laryngectomy:a single-institution experience,2001-2012[J].Am J Otolaryngol,2015,36:24-31.
[9]LIANG J W,LI Z D,LI S C,et al.Pharyngocutaneous fistula after total laryngectomy:A systematic review and meta-analysis of risk factors[J].Auris Nasus Larynx,2015,42:353-359.
[10]BUSONI M,DEGANELLO A,GALLO O.Pharyngocutaneous fistula following total laryngectomy:analysis of risk factors,prognosis and treatment modalities[J].Acta Otorhinolaryngol Ital,2015,35:400-405.
[11]PARZEFALL T,WOLF A,CZEIGER S,et al.Effect of postoperative use of diclofenac on pharyngocutaneous fistula development after primary total laryngopharyngectomy:Results of a single-center retrospective study[J].Head Neck,2016,38:E1515-E1520.
[12]VASANI S S,YOUSSEF D,LIN C,et al.Defining the low-risk salvage laryngectomy-A single-center retrospective analysis of pharyngocutaneous fistula[J].Laryngoscope Investig Otolaryngol,2018,3:115-120.
[13]LI R J,ZHOU X C,FAKHRY C,et al.Reduction of Pharyngocutaneous Fistulae in Laryngectomy Patients by a Comprehensive Performance Improvement Intervention[J].Otolaryngol Head Neck Surg,2015,153:927-934.
[14]CANNON R B,HOULTON J J,MENDEZ E,et al.Methods to reduce postoperative surgical site infections after head and neck oncology surgery[J].Lancet Oncol,2017,18:e405-e413.
[15]STATHAS T,MALLIS A,MASTRONIKOLIS NS,et al.Pharyngocutaneous fistula complicating laryngectomy:can metronidazole help[J]?ORL J Otorhinolaryngol Relat Spec,2011,73:291-294.
[16]JOHANSEN L V,OVERGAARD J,ELBROND O.Pharyngo-cutaneous fistulae after laryngectomy.Influence of previous radiotherapy and prophylactic metronidazole[J].Cancer,1988,61:673-678.
[17]高云飞,刘丽然,李明天,等.全喉术中密闭性检测预防术后咽瘘临床意义探讨[J].中华肿瘤防治杂志,2018,25(11):796-798.
[18]王文武,魏小林,苏纪平.线型闭合器在全喉切除术中的应用现状[J].临床耳鼻咽喉头颈外科杂志,2017,31(1):78-81.
[19]WALTON B,VELLUCCI J,PATEL P B,et al.Post-Laryngectomy stricture and pharyngocutaneous fistula:Review of techniques in primary pharyngeal reconstruction in laryngectomy[J].Clin Otolaryngol,2018,43:109-116.
[20]SHAN H,GAO Y,LIU L,et al.Magnifying endoscopy with narrow-band imaging to assist the linear stapler closure of the pharynx during total laryngectomy[J].Am J Otolaryngol,2018,39:511-514.
[21]HAKSEVER M,AKDUMAN D,ASLAN S,et al.Modified Continuous Mucosal Connell Suture for the Pharyngeal Closure After Total Laryngectomy:Zipper Suture[J].Clin Exp Otorhinolaryngol,2015,8:281-288.
[22]DENIZ M,CIFTCI Z,GULTEKIN E.Pharyngoesophageal Suturing Technique May Decrease the Incidence of Pharyngocutaneous Fistula following Total Laryngectomy[J].Surg Res Pract,2015,2015:363640.
[23]SCOTTON W J,NIXON I J,PEZIER T F,et al.Time interval between primary radiotherapy and salvage laryngectomy:apredictor of pharyngocutaneous fistula formation[J].Eur Arch Otorhinolaryngol,2014,271:2277-2283.
[24]SHARAF B,XUE A,SOLARI M G,et al.Optimizing Outcomes in Pharyngoesophageal Reconstruction and Neck Resurfacing:10-Year Experience of 294Cases[J].Plast Reconstr Surg,2017,139:105e-119e.
[25]PATEL U A,MOORE B A,WAX M,et al.Impact of pharyngeal closure technique on fistula after salvage laryngectomy[J].JAMA Otolaryngol Head Neck Surg,2013,139:1156-1162.
[26]PALERI V,DRINNAN M,VAN DEN BREKEL MW,et al.Vascularized tissue to reduce fistula following salvage total laryngectomy:a systematic review[J].Laryngoscope,2014,124:1848-1853.
[27]GENDREAU-LEFEVRE A K,AUDET N,MAL-TAIS S,et al.Prophylactic pectoralis major muscle flap in prevention of pharyngocutaneous fistula in total laryngectomy after radiotherapy[J].Head Neck,2015,37:1233-1238.
[28]GUIMARAES A V,AIRES F T,DEDIVITIS R A,et al.Efficacy of pectoralis major muscle flap for pharyngocutaneous fistula prevention in salvage total laryngectomy:A systematic review[J].Head Neck,2016,38:E2317-E2321.
[29]ANSCHUTZ L,NISA L,ELICIN O,et al.Pectoralis major myofascial interposition flap prevents postoperative pharyngocutaneous fistula in salvage total laryngectomy[J].Eur Arch Otorhinolaryngol,2016,273:3943-3949.
[30]CHIESA E C,GONZALEZ G J,SISTIAGA S J,et al.Efficacy of the myofascial pectoralis major flap in the reduction of salivary fistulas after salvage total laryngectomy[J].Acta Otorrinolaringol Esp,2018,69:99-104.
[31]KHAN N A,MEDINA J E,SANCLEMENT J A,et al.Fistula rates after salvage laryngectomy:comparing pectoralis myofascial and myocutaneous flaps[J].Laryngoscope,2014,124:1615-1617.
[32]SHARMA S,CHAUKAR D A,LASKAR S G,et al.Role of the pectoralis major myofascial flap in preventing pharyngocutaneous fistula following salvage laryngectomy[J].J Laryngol Otol,2016,130:860-864.
[33]SITTITRAI P,SRIVANITCHAPOOM C,REUN-MAKKAEW D.Prevention of pharyngocutaneous fistula in salvage total laryngectomy:role of the pectoralis major flap and peri-operative management[J].JLaryngol Otol,2018,132:246-251.
[34]GILBERT M R,STURM J J,GOODING W E,et al.Pectoralis major myofascial onlay and myocutaneous flaps and pharyngocutaneous fistula in salvage laryngectomy[J].Laryngoscope,2014,124:2680-2686.
[35]POWELL J,ULLAL U R,AHMED O,et al.Tissue transfer to post-chemoradiation salvage laryngectomy defects to prevent pharyngocutaneous fistula:singlecentre experience[J].J Laryngol Otol,2014,128:365-367.
[36]KAO H K,ABDELRAHMAN M,CHANG K P,et al.Choice of flap affects fistula rate after salvage laryngopharyngectomy[J].Sci Rep,2015,5:9180-9184.
[37]KADOTA H,FUKUSHIMA J,KAMIZONO K,et al.A minimally invasive method to prevent postlaryngectomy major pharyngocutaneous fistula using infrahyoid myofascial flap[J].J Plast Reconstr Aesthet Surg,2013,66:906-911.
[38]NAGHIBZADEH M,ZOJAJI R,MOKHTARI A-MIR MAJDI N,et al.Using a sternocleidomastoid muscle flap to prevent postoperative pharyngocutaneous fistula after total laryngectomy:a study of 88cases[J].Ear Nose Throat J,2014,93:362-365.
[39]IBRAHIM S G,WAHBA B M,ELBATAWI A M,et al.Sternocleidomastoid flap augmentation of the pharyngeal closure after total laryngectomy[J].Eur Arch Otorhinolaryngol,2017,274:3197-3202.
[40]AIRES F T,DEDIVITIS R A,PETRAROLHA SM,et al.Early oral feeding after total laryngectomy:A systematic review[J].Head Neck,2015,37:1532-1535.
[41]BONDI S,GIORDANO L,LIMARDO P,et al.Role of Montgomery salivary stent placement during pharyngolaryngectomy,to prevent pharyngocutaneous fistula in high-risk patients[J].J Laryngol Otol,2013,127:54-57.
[42]KAMHIEH Y,FOX H,HALLETT E,et al.Routine use of salivary bypass tubes in laryngectomy patients:systematic review[J].J Laryngol Otol,2018,132:380-384.
[43]HONE R,RAHMAN E,WONG G,et al.Do salivary bypass tubes lower the incidence of pharyngocutaneous fistula following total laryngectomy?A retrospective analysis of predictive factors using multivariate analysis[J].Eur Arch Otorhinolaryngol,2017,274:1983-1991.
[44]ERYILMAZ A,DEMIRCI B,GUNEL C,et al.Can tissue adhesives and platelet-rich plasma prevent pharyngocutaneous fistula formation[J]?Auris Nasus Larynx,2016,43:62-67.
[45]LEE D W,CHUNG S,LEE W J,et al.Use of a collagen patch for management of pharyngocutaneous fistula after hypopharyngeal reconstruction[J].JCraniofac Surg,2010,21:1674-1676.
[46]DEMIR B,SARI M,BINNETOGLU A,et al.Comparison of pharyngocutaneous fistula closure with and without bacterial cellulose in a rat model[J].Auris Nasus Larynx,2018,45:301-305.
[47]TIMMERMANS A J,LANSAAT L,KROON G V,et al.Early oral intake after total laryngectomy does not increase pharyngocutaneous fistulization[J].Eur Arch Otorhinolaryngol,2014,271:353-358.
[48]SUSLU N,SEFIK H A.Early oral feeding after total laryngectomy:Outcome of 602patients in one cancer center[J].Auris Nasus Larynx,2016,43:546-550.