ArticlePloS one2026
Pharyngocutaneous fistula after total laryngectomy: Prevalence and risk factors.
Article in PloS one, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveTo determine the prevalence and identify associated risk factors of pharyngocutaneous fistula following total laryngectomy.
methodsMedical records of 160 patients diagnosed with laryngeal cancer between 2000-2021, subsequently undergoing total laryngectomy at Karolinska University Hospital, were analyzed for demographics, comorbidities, tumor characteristics, treatments and postoperative outcomes. Uni- and multivariate analyses were used to identify risk factors for pharyngocutaneous fistula.
resultsPharyngocutaneous fistula developed in 28 patients (17.5%). Univariate analysis identified cardiovascular disease (OR 2.50; 95% CI 1.00-6.28), preoperative hemoglobin <110 g/L (OR 5.34; 95% CI 1.74-16.45), prior radiotherapy (OR 3.78; 95% CI 1.24-11.52), preoperative tracheostomy (OR 2.44; 95% CI 1.05-5.72), pharyngectomy (OR 8.47; 95% CI 2.46-29.17), neck dissection (OR 2.52; 95% CI 1.06-6.00), pectoral flap reconstruction (OR 10.83; 95% CI 1.88-62.49) and postoperative infection (OR 28.44; 95% CI 9.00-89.81) as significant risk factors. In multivariate analysis only pharyngectomy (OR 7.18; 95% CI 1.08-47.63; p = 0.041) and postoperative infection (OR 24.94; 95% CI 6.66-93.46; p < 0.001) remained independent.
conclusionsPharyngocutaneous fistula is a common complication occurring in 17.5% of patients following total laryngectomy. Pharyngectomy and postoperative infection are independent risk factors for fistula formation.
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