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Risk factors of pharyngocutaneous fistula after total laryngectomy: a systematic review and meta-analysis

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Abstract

Objective

The purpose of this study was to systematically evaluate the risk factors of pharyngocutaneous fistula (PCF) after total laryngectomy.

Methods

We systematically searched Pubmed, Web of Science, Cochrane Library, and Embase databases and included the literature according to the inclusion and exclusion criteria.

Results

A total of 52 studies with 8605 patients were included in the meta-analysis. The total incidence of PCF was 21% (1808/8605). Meta-analysis results indicated that age (OR = 1.29, 95% CI 1.06–1.58, P = 0.01), smoking (OR = 1.62, 95% CI 1.27–2.07, P < 0.01), COPD (chronic obstructive pulmonary disease) (OR = 1.62, 95% CI 1.19–2.22, P < 0.01), CAD (coronary atherosclerotic heart disease) (OR = 1.82, 95% CI 1.36–2.45, P < 0.01), T-stage (OR = 0.81, 95% CI 0.67–0.98, P = 0.03), previous radiotherapy (OR = 2.41, 95% CI 2.00–2.90, P < 0.01), preoperative albumin (OR = 2.95, 95% CI 1.47–5.91, P < 0.01), preoperative hemoglobin (OR = 1.97, 95% CI 1.28–3.03, P < 0.01), tumor site (OR = 0.28, 95% CI 0.22–0.36, P < 0.01), and treatment method (OR = 1.85, 95% CI 1.44–2.38, P < 0.01) were risk factors associated with PCF.

Conclusions

In our study, age, smoking, COPD, CAD, T-stage, previous radiotherapy, preoperative albumin, preoperative hemoglobin, tumor site, and treatment method were risk factors of PCF.

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Data availability

The data sets used and analyzed during the current study are available from references on reasonable request.

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Acknowledgements

We would like to thank Professors Bing Guan and Chenjie Yu for reviewing and providing advice on the final search strategy. We thank LetPub (https://www.letpub.com) for its linguistic assistance during the preparation of this manuscript.

Funding

This work was supported by grants from Nanjing Medical Science and Technique Development Foundation (No. QRX17051). The Project of Invigorating Health Care through Science, Technology and Education (No. ZDXKB2016015).

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Author notes

  1. Maohua Wang and Youfang Xun are co-first authors.

Authors and Affiliations

  1. Department of Otolaryngology, Head and Neck Surgery, XiangYa School of Medicine, Central South University, Changsha, 410000, People’s Republic of China

    Maohua Wang & Youfang Xun

  2. Department of Otolaryngology, Head and Neck Surgery, Clinical Medical College of Yangzhou University, Yangzhou, 225001, People’s Republic of China

    Aimin Yu & Bing Guan

  3. Department of Otolaryngology, Head and Neck Surgery, Drum Tower Clinical Medical College, Nanjing Medical University, Nanjing, 210008, People’s Republic of China

    Kaijian Wang, Ling Lu & Chenjie Yu

  4. Department of Otolaryngology, Head and Neck Surgery, Affiliated Drum Tower Hospital of Nanjing University Medical School, Jiangsu Provincial Key Medical Discipline (Laboratory), Nanjing, 210008, People’s Republic of China

    Ling Lu & Chenjie Yu

  5. Research Institute of Otolaryngology, Nanjing, 210008, People’s Republic of China

    Chenjie Yu

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  1. Maohua Wang
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Wang, M., Xun, Y., Wang, K. et al. Risk factors of pharyngocutaneous fistula after total laryngectomy: a systematic review and meta-analysis. Eur Arch Otorhinolaryngol 277, 585–599 (2020). https://doi.org/10.1007/s00405-019-05718-9

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