Use of surgical sealant in the prevention of pharyngocutaneous fistula after total laryngectomy

Head Neck. 2018 Dec;40(12):2606-2611. doi: 10.1002/hed.25334. Epub 2018 Nov 28.

Abstract

Background: Pharyngocutaneous fistula is a major wound complication of total laryngectomy. Surgical sealants may be used to increase the strength and/or integrity of surgical repairs. The purpose of this study was to present our evaluation of the feasibility and utility of the application of sealant to the pharyngeal repair with the aim of reducing pharyngocutaneous fistula incidence.

Methods: This was a prospective single-blind randomized controlled study; patients undergoing primary total laryngectomy for advanced carcinoma of the larynx were randomized into control and treatment (albumin-polyaldehyde sealant applied to pharyngeal repair) groups. Relevant patient, disease, and management-related factors were recorded.

Results: Forty-five patients were included (23 controls and 22 who received treatments). No difference in the incidence of pharyngocutaneous fistula was observed between the 2 groups. No treatment-related complications occurred.

Conclusion: Feasibility of application of an albumin-polyaldehyde surgical sealant to the pharyngeal repair was demonstrated, however, a pharyngocutaneous fistula-preventative effect was not observed. Larger animal and clinical studies are encouraged to clarify this finding.

Keywords: laryngectomy; pharyngocutaneous fistula; prophylactic; surgical sealant; tissue adhesive.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Cutaneous Fistula / prevention & control*
  • Female
  • Fistula / prevention & control
  • Humans
  • Laryngeal Neoplasms / surgery*
  • Laryngectomy / adverse effects*
  • Male
  • Middle Aged
  • Neck Dissection
  • Pharyngeal Diseases / prevention & control*
  • Pharynx
  • Postoperative Complications / prevention & control*
  • Prospective Studies
  • Single-Blind Method
  • Tissue Adhesives*

Substances

  • Tissue Adhesives