Metta-analysis Of Risk Factos Of Pharyngocutaneous Fistula In Patients With Aryngealor Hypopharynegeal Carcinoma After Total Laryngectomy

OBJECTIVE To evaluate the risk factors of pharyngocutaneous fistula(PCF) in patients with Laryngealor hypopharyngeal Carcinoma after total laryngectomy and help us prevent the complications. METHODS According to the requirements of Cochrane systematic review, a thorough literature search was performed among MEDLINE,EMBASE,Chinese Digital Hospital Library,Chinese Biomedical Literature Disk Database and Chinese Scientific Journals Database of VIP. Meta analysis was performed on a total of 4091 patients in 26 papers which met the inclusion criteria. Data was analyzed by RevMan4.2 software. RESULTs All candidates for the total incidence rate of PCF is 16.72%. Meta analysis results indicate that the incidence rate of PCF was higher in T3T4 patients (OR 0.49, P <0.0001), prior tracheostomy (OR 1.73, P=0.02). preoperative radiotherapy (OR 3.39, P<0.00001), supraglottic and glottic-cross patients (OR 2.49, P=0.0003), concurrent neck dissection (OR 1.58, P=0.002), whose duration of surgery is over 4 hours (OR 2.95, P<0.00001), whose postoperative hemoglobin level less than 120g/L (OR 2.03, P=0.0004)and in patients with systemic disease(OR 6.56 P=0.0001). CONCLUSION primary tumor site, tumor T stage, concurrent neck dissection, prior tracheostomy, preoperative radiotherapy, duration of surgery, lower postoperative hemoglobin, concurent illness are risk factors of pharyngocutaneous fistula...