Early oral hydration protects against pharyngocutaneous fistula after total laryngectomy or total pharyngolaryngectomy

Head Neck. 2020 Aug;42(8):1902-1906. doi: 10.1002/hed.26122. Epub 2020 Mar 3.

Abstract

Background: The objective of this study was to evaluate the impact of early oral hydration on the incidence of pharyngocutaneous fistula (PCF) after total laryngectomy (TL) or total pharyngolaryngectomy (TPL).

Methods: A prospective series of 25 patients operated on between October 2017 and March 2019 who received early oral hydration starting 2 days after surgery were compared to a retrospective cohort of 28 patients who did not receive any early oral hydration. These are two consecutive series including all operated patients.

Results: There was no significant difference between the two groups in terms of risk factors for PCF. In univariate and multivariate analysis, early oral hydration was significantly associated with a decreased risk of PCF: 50% vs 20% (odds ratio [OR], 0.25; 95% confidence interval [95% CI], 0.07-0.85; P = .03, vs OR, 0.24; 95% CI, 0.07-0.85; P = .02).

Conclusion: Early oral hydration after TL or TPL reduces the risk of PCF.

Keywords: early oral hydration; incidence; pharyngocutaneous fistula; postlaryngectomy complications; protective factor.

MeSH terms

  • Cutaneous Fistula* / epidemiology
  • Cutaneous Fistula* / etiology
  • Cutaneous Fistula* / prevention & control
  • Humans
  • Laryngeal Neoplasms* / surgery
  • Laryngectomy
  • Pharyngeal Diseases* / epidemiology
  • Pharyngeal Diseases* / etiology
  • Pharyngeal Diseases* / prevention & control
  • Postoperative Complications / epidemiology
  • Postoperative Complications / prevention & control
  • Prospective Studies
  • Retrospective Studies