Modified vacuum-assisted closure (EndoVAC) therapy for treatment of pharyngocutaneous fistula: Case series and a review of the literature

Head Neck. 2021 Aug;43(8):2377-2384. doi: 10.1002/hed.26684. Epub 2021 Apr 8.

Abstract

Background: Pharyngocutaneous fistula is a potential life-threatening complication following head and neck surgery. There is only limited evidence about the efficacy of vacuum-assisted closure (VAC) therapy and endoscopic vacuum-assisted closure (EndoVAC) therapy for the treatment of pharyngocutaneous fistulas.

Methods: In this article, we report on a consecutive case series of six male patients with pharyngocutaneous fistula treated with a modified outside-in EndoVAC technique. We also present a review of the current related literature.

Results: EndoVAC therapy alone was successful in five of the six patients (83.3%) with a median duration of EndoVAC therapy of 18.5 days (range: 7 to 32 days) and a median number of EndoVAC sponge changes of 4 (range: 1 to 9 changes). One patient needed additional reconstructive surgery after prior radiochemotherapy and jejunal transfer. No treatment-related complications were observed.

Conclusion: EndoVAC therapy is an easy-to-perform, safe procedure for the treatment of pharyngocutaneous fistulae.

Keywords: head and neck cancer; laryngectomy; negative-pressure wound therapy; radiochemotherapy; salvage surgery.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Cutaneous Fistula* / surgery
  • Cutaneous Fistula* / therapy
  • Endoscopy
  • Humans
  • Laryngectomy
  • Male
  • Negative-Pressure Wound Therapy*
  • Pharyngeal Diseases* / surgery
  • Pharyngeal Diseases* / therapy
  • Postoperative Complications
  • Retrospective Studies