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

Matthieu Le Flem (1) , Laure Santini (1) , Carole Boulze (1) , Abdallah Alshukry (1) , Antoine Giovanni (1, 2) , Patrick Dessi (1) , Nicolas Fakhry (1, 2)

1 LA CONCEPTION - Hôpital de la Conception [CHU - APHM]
2 LPL - Laboratoire Parole et Langage

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.

Mots clés: postlaryngectomy complications; protective factor; early oral hydration; incidence; pharyngocutaneous fistula

Domaines: Sciences du Vivant [q-bio]

Matthieu Le Flem, Laure Santini, Carole Boulze, Abdallah Alshukry, Antoine Giovanni, et al.. Early oral hydration protects against pharyngocutaneous fistula after total laryngectomy or total pharyngolaryngectomy. Head & Neck, 2020, 42 (8), pp.1902-1906. ⟨10.1002/hed.26122⟩. ⟨hal-03222478⟩