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The effect of salivary bypass tube use on the prevention of pharyngo-cutaneous fistulas after total laryngectomy

par Bohlok, Ali ;Richet, Théo ;Quiriny, marie;Willemse, Esther ;Dekeyser, Cécile;Andry, Guy ;Donckier De Donceel, Vincent ;Digonnet, Antoine
Référence European archives of oto-rhino-laryngology
Publication Publié, 2021-09-01

Article révisé par les pairs

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Résumé :

Introduction: The aim of this retrospective study was to assess the efficacy of Salivary Bypass Tube (SBT) for preventing pharyngo-cutaneous fistula (PCF) in a recent cohort of patients who underwent primary and salvage total laryngectomy (TL). Methods: A consecutive series of 133 patients who underwent total laryngectomy between 1997 and 2019 was reviewed. The incidence of PCF was compared between patients who did not receive SBT (nSBT group; n = 55) and those preventively receiving SBT (SBT group; n = 78) in both primary and salvage TL. Risk factors for PCF were evaluated in a univariate and multivariate analyses. Results: The overall PCF rate was 30%. Preoperative characteristics were similar between the nSBT and SBT groups, except for older age (p = 0.016), lower preoperative hemoglobin (p = 0.043), and lesser neoadjuvant chemotherapy (p = 0.015) in the SBT group. The rate of PCF the nSBT group, was 41.5%, compared to 21.8% in the SBT group (p = 0.020). In multivariate analysis, only the use of SBT was associated with lower risk of PCF (OR = 0.41 (95% CI 0.19–0.89), p = 0.026). This effect was verified only in the subgroup of patient operated for salvage TL (OR = 0.225; 95% CI 0.09–0.7; p = 0.008). Conclusion: The use of SBT in our series in salvage TL, appears to be associated with a decreased risk of PCF.