A modified vertical pressure bandage to prevent pharyngocutaneous fistula after total laryngectomy

Objective: Pharyngocutaneous Fistula (PCF) is one of the most common and challenging postoperative complications after Total Laryngectomy (TLE). This study aimed to evaluate the impact of the modified Vertical Pressure Bandage (VPB) on the occurrence of Pharyngocutaneous Fistula (PCF) after Total La...

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Main Authors: Xuwei Duan, Jian Xu, Xueqin Liu, Duoping Wang, Biaoyou Chen
Format: Article
Language:English
Published: Elsevier 2025-03-01
Series:Brazilian Journal of Otorhinolaryngology
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Online Access:http://www.sciencedirect.com/science/article/pii/S1808869424001526
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author Xuwei Duan
Jian Xu
Xueqin Liu
Duoping Wang
Biaoyou Chen
author_facet Xuwei Duan
Jian Xu
Xueqin Liu
Duoping Wang
Biaoyou Chen
author_sort Xuwei Duan
collection DOAJ
description Objective: Pharyngocutaneous Fistula (PCF) is one of the most common and challenging postoperative complications after Total Laryngectomy (TLE). This study aimed to evaluate the impact of the modified Vertical Pressure Bandage (VPB) on the occurrence of Pharyngocutaneous Fistula (PCF) after Total Laryngectomy (TLE) for Head and Neck (H&N) cancer. Methods: This retrospective study included patients with H&N cancer who underwent TLE at our hospital between January 2010 and January 2021. The patients were grouped according to whether modified VPB was used or not after surgery. The primary outcome was the occurrence of PCF. The secondary outcomes were the interval from operation to PCF, the healing time of PCF, and the length of hospital stay. Results: This study included 133 patients: 82 (aged 57.93 ± 10.18 years, 80 males) in the VPB group and 51 (aged 54.98 ± 9.22 years, 51 males) in the conventional group. Patients who received the modified VPB had a significantly lower occurrence of PCF compared with those did not (9.8% vs. 33.3%, p = 0.001). In addition, the patients in the VPB group had similar interval from the operation to the PCF (p = 0.374) and healing time of PCF (p = 0.256) but a significantly shorter length of hospital stay (p < 0.001) compared with those in conventional group. Moreover, multivariable logistic regression analysis showed that, after adjusting for age, preoperative radiotherapy, postoperative hematocrit < 35%, VPB (RR = 0.165, 95% CI 0.057‒0.474, p = 0.001) was an independent protective factor for PCF. Conclusion: The modified VPB might reduce the occurrence of PCF after TLE for H&N cancers. Level of evidence: Level 4.
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spelling doaj-art-d17cb6ab0cc4460181b064d90d8a12372025-08-20T02:26:14ZengElsevierBrazilian Journal of Otorhinolaryngology1808-86942025-03-0191210153710.1016/j.bjorl.2024.101537A modified vertical pressure bandage to prevent pharyngocutaneous fistula after total laryngectomyXuwei Duan0Jian Xu1Xueqin Liu2Duoping Wang3Biaoyou Chen4Guangxi Medical University Cancer Hospital, Department of Head and neck Surgery, Nanning, ChinaGuangxi Medical University Cancer Hospital, Department of Head and neck Surgery, Nanning, China; Corresponding authors.Guangxi Medical University Cancer Hospital, Department of Hospital Quality Control Management, Nanning, China; Corresponding authors.Guangxi Medical University Cancer Hospital, Department of Head and neck Surgery, Nanning, ChinaGuangxi Medical University Cancer Hospital, Department of Head and neck Surgery, Nanning, ChinaObjective: Pharyngocutaneous Fistula (PCF) is one of the most common and challenging postoperative complications after Total Laryngectomy (TLE). This study aimed to evaluate the impact of the modified Vertical Pressure Bandage (VPB) on the occurrence of Pharyngocutaneous Fistula (PCF) after Total Laryngectomy (TLE) for Head and Neck (H&N) cancer. Methods: This retrospective study included patients with H&N cancer who underwent TLE at our hospital between January 2010 and January 2021. The patients were grouped according to whether modified VPB was used or not after surgery. The primary outcome was the occurrence of PCF. The secondary outcomes were the interval from operation to PCF, the healing time of PCF, and the length of hospital stay. Results: This study included 133 patients: 82 (aged 57.93 ± 10.18 years, 80 males) in the VPB group and 51 (aged 54.98 ± 9.22 years, 51 males) in the conventional group. Patients who received the modified VPB had a significantly lower occurrence of PCF compared with those did not (9.8% vs. 33.3%, p = 0.001). In addition, the patients in the VPB group had similar interval from the operation to the PCF (p = 0.374) and healing time of PCF (p = 0.256) but a significantly shorter length of hospital stay (p < 0.001) compared with those in conventional group. Moreover, multivariable logistic regression analysis showed that, after adjusting for age, preoperative radiotherapy, postoperative hematocrit < 35%, VPB (RR = 0.165, 95% CI 0.057‒0.474, p = 0.001) was an independent protective factor for PCF. Conclusion: The modified VPB might reduce the occurrence of PCF after TLE for H&N cancers. Level of evidence: Level 4.http://www.sciencedirect.com/science/article/pii/S1808869424001526Pharyngocutaneous fistulaModified vertical pressure bandageTotal laryngectomyRetrospective study
spellingShingle Xuwei Duan
Jian Xu
Xueqin Liu
Duoping Wang
Biaoyou Chen
A modified vertical pressure bandage to prevent pharyngocutaneous fistula after total laryngectomy
Brazilian Journal of Otorhinolaryngology
Pharyngocutaneous fistula
Modified vertical pressure bandage
Total laryngectomy
Retrospective study
title A modified vertical pressure bandage to prevent pharyngocutaneous fistula after total laryngectomy
title_full A modified vertical pressure bandage to prevent pharyngocutaneous fistula after total laryngectomy
title_fullStr A modified vertical pressure bandage to prevent pharyngocutaneous fistula after total laryngectomy
title_full_unstemmed A modified vertical pressure bandage to prevent pharyngocutaneous fistula after total laryngectomy
title_short A modified vertical pressure bandage to prevent pharyngocutaneous fistula after total laryngectomy
title_sort modified vertical pressure bandage to prevent pharyngocutaneous fistula after total laryngectomy
topic Pharyngocutaneous fistula
Modified vertical pressure bandage
Total laryngectomy
Retrospective study
url http://www.sciencedirect.com/science/article/pii/S1808869424001526
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