Factors Of Pharyngocutaneous Fistula Following Total Laryngectomy

Objective: To investigate the factors of pharyngocutaneous fistula as a complication of total laryngectomy.Methods: The postoperative courses of 85 patients who underwent total laryngectomy were reviewed from the second affiliated hospital of Nanhua university and the tumor hospital of Hunan province from September 2000 to March 2005.Results: The rate of pharyngocutaneous fistula following total laryngectomy was 8.24% (7/85). The mean hospitalization time was 11 days, ranging from 5 to 20 days. The rate of pharyngocutaneous fistula (26.67%) with adiotherapy before surgery was significantly higher than that (4.29%) without adiotherapy before surgery (P<0.05). The rate of pharyngocutaneous fistula (75.00%) with affection after surgery was significantly higher than that (1.30%) without affection after surgery (P<0.05).Conclusion: Pharyngocutaneous fistula is closely related to the adiotherapy before surgery and affection after surgery. Objective: To investigate the significance of the expression of cathepsin D (CD) in laryngeal squamous cell carcinoma (LSCC).Methods: 20 patients with normal laryngeal mucosa, 20 with dysplasia laryngeal mucosa and 60 with primary LSCC were selected from the department of pathology of the second and the first affiliated hospital of Nanhua university from September 2005 to March 2010. The micromo- rphology of these specimens was observed with HE method. The expression of CD was determined with S-P immunohistochemical method and the relationships between the results and the clinicopathological features of the patients were assessed.Results: The positive expression rates of CD in normal laryngeal mucosa,dysplasia laryngeal mucosa and LSCC were 0.00% ( 0/20 ), 15.00% ( 3/20) and 81.67% ( 49/60).The positive expression rates of CD (81.67%) in LSCC was significantly higher than those in normal laryngeal mucosa and dysplasia laryngeal mucosa (P<0.01).The positive expression of CD in cancer cells were correlated with the tumor invasive depth and lymph node metastasis (P<0.05).Conclusion: LSCC highly expresses CD. The expression of CD in cancer cells are closely related to the tumor invasion and lymphatic metastasis of LSCC, which suggest that they may be useful prognostic marker for LSCC.