Risk factors of pharyngocutaneous fistula following total laryngectomy

Background: Total laryngectomy is the procedure of removing the entire laryngeal structure. The purpose of this study was to analyze the risk factors for postoperative total pharyngocutaneous fistula. Methods: This was a retrospective study using medical record data with cross-sectional design. This research was conducted at Dr. Soetomo Surabaya, Indonesia from January 1, 2016 to December 31, 2018. Results: The prevalence of pharyngocutaneous fistula was 14 patients (17.07%) of 82 patients with laryngeal carcinoma. Age factors (p = 0.243), sex (p = 1.000), previous smoking history (p = 0.506), history of type 2 diabetes mellitus (p = 1.000), histopathology (p = 0.076), stage (p = 1,000), tumor location (p = 0.183), incision technique (p = 0.924), preoperative hemoglobin levels (p = 0.669), and preoperative albumin levels (p = 1.00) were not found to be significantly associated with complications of pharyngocutaneous fistula. However, there was a significant relationship between neck dissection and pharyngocutaneous fistula complications (p = 0.023, OR = 6.8, 95% CI 1.373-33.867). Patients with neck dissection had the possibility to experience complications of pharyngocutaneous fistula 6.8 times higher compared to those without neck dissection. Conclusion: There is a relationship between neck dissection and pharyngocutaneous fistula complications.