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European Archives of Oto-Rhino-Laryngology

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Open Access 01-04-2017 | Head and Neck

Do salivary bypass tubes lower the incidence of pharyngocutaneous fistula following total laryngectomy? A retrospective analysis of predictive factors using multivariate analysis

Authors: Robert W. A. Hone, Eqramur Rahman, Gentle Wong, Yvette Annan, Victoria Alexander, Ali Al-Lami, Kiran Varadharajan, Michael Parker, Ricard Simo, Lisa Pitkin, Alasdair Mace, Enyinnaya Ofo, Alistair Balfour, Iain J. Nixon

Published in: European Archives of Oto-Rhino-Laryngology | Issue 4/2017

Abstract

Salivary bypass tubes (SBT) are increasingly used to prevent pharyngocutaneous fistula (PCF) following laryngectomy and pharyngolaryngectomy. There is minimal evidence as to their efficacy and literature is limited. The aim of the study was to determine if SBT prevent PCF. The study was a multicentre retrospective case control series (level of evidence 3b). Patients who underwent laryngectomy or pharyngolaryngectomy for cancer or following cancer treatment between 2011 and 2014 were included in the study. The primary outcome was development of a PCF. Other variables recorded were age, sex, prior radiotherapy or chemoradiotherapy, prior tracheostomy, type of procedure, concurrent neck dissection, use of flap reconstruction, use of prophylactic antibiotics, the suture material used for the anastomosis, tumour T stage, histological margins, day one post-operative haemoglobin and whether a salivary bypass tube was used. Univariate and multivariate analysis were performed. A total of 199 patients were included and 24 received salivary bypass tubes. Fistula rates were 8.3% in the SBT group (2/24) and 24.6% in the control group (43/175). This was not statistically significant on univariate (p value 0.115) or multivariate analysis (p value 0.076). In addition, no other co-variables were found to be significant. No group has proven a benefit of salivary bypass tubes on multivariate analysis. The study was limited by a small case group, variations in tube duration and subjects given a tube may have been identified as high risk of fistula. Further prospective studies are warranted prior to recommendation of salivary bypass tubes following laryngectomy.

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Title: Do salivary bypass tubes lower the incidence of pharyngocutaneous fistula following total laryngectomy? A retrospective analysis of predictive factors using multivariate analysis
Authors: Robert W. A. Hone
Eqramur Rahman
Gentle Wong
Yvette Annan
Victoria Alexander
Ali Al-Lami
Kiran Varadharajan
Michael Parker
Ricard Simo
Lisa Pitkin
Alasdair Mace
Enyinnaya Ofo
Alistair Balfour
Iain J. Nixon
Publication date: 01-04-2017
Publisher: Springer Berlin Heidelberg
Published in: European Archives of Oto-Rhino-Laryngology / Issue 4/2017
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI: https://doi.org/10.1007/s00405-016-4391-9

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Springer Medicine

Do salivary bypass tubes lower the incidence of pharyngocutaneous fistula following total laryngectomy? A retrospective analysis of predictive factors using multivariate analysis

Abstract

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Abstract

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