Reducing the rate of fistula: does a fibrin sealant act as an adjunct in pharyngeal closure? A two-centre experience.
Fibrin Tissue Adhesive
Fistula
Laryngectomy
Pharyngectomy
Journal
The Journal of laryngology and otology
ISSN: 1748-5460
Titre abrégé: J Laryngol Otol
Pays: England
ID NLM: 8706896
Informations de publication
Date de publication:
Jul 2020
Jul 2020
Historique:
pubmed:
4
8
2020
medline:
9
9
2020
entrez:
4
8
2020
Statut:
ppublish
Résumé
Pharyngocutaneous fistula is a troublesome complication. Recently, synthetic materials such as fibrin sealant have been used as a secondary measure to treat fistula. This work assessed whether the primary use of fibrin sealant can reduce the rate of fistula. A retrospective review of 50 cases from 2 centres was completed. Tisseel was an adjunct to primary closure in all cases. In the first centre, 3 out of 34 cases developed pharyngocutaneous fistula (fistula rate of 9 per cent). All three were salvage cases. In the second centre, 0 out of 16 cases developed a fistula. The incidence of pharyngocutaneous fistula post-radiation and post-chemoradiotherapy in laryngectomy cases has been quoted as 23 per cent and 34 per cent respectively. This study represents the first patient series on the use of fibrin sealant as an adjunct in primary closure following laryngectomy. The results are promising, encouraging the use of Tisseel as an adjunct to meticulous closure.
Sections du résumé
BACKGROUND
BACKGROUND
Pharyngocutaneous fistula is a troublesome complication. Recently, synthetic materials such as fibrin sealant have been used as a secondary measure to treat fistula. This work assessed whether the primary use of fibrin sealant can reduce the rate of fistula.
METHOD
METHODS
A retrospective review of 50 cases from 2 centres was completed. Tisseel was an adjunct to primary closure in all cases.
RESULTS
RESULTS
In the first centre, 3 out of 34 cases developed pharyngocutaneous fistula (fistula rate of 9 per cent). All three were salvage cases. In the second centre, 0 out of 16 cases developed a fistula.
CONCLUSION
CONCLUSIONS
The incidence of pharyngocutaneous fistula post-radiation and post-chemoradiotherapy in laryngectomy cases has been quoted as 23 per cent and 34 per cent respectively. This study represents the first patient series on the use of fibrin sealant as an adjunct in primary closure following laryngectomy. The results are promising, encouraging the use of Tisseel as an adjunct to meticulous closure.
Identifiants
pubmed: 32741379
doi: 10.1017/S0022215120001218
pii: S0022215120001218
doi:
Substances chimiques
Fibrin Tissue Adhesive
0
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM