%0 Journal Article
%T Fatores preditores de f¨ªstula salivar p¨®s-laringectomia total Predictors of salivary fistula after total laryngectomy
%A Alexandre de Andrade Sousa
%A Jos¨¦ Maria Porcaro-Salles
%A Jo£¿o Marcos Arantes Soares
%A Gustavo Meyer de Moraes
%J Revista do Col¨¦gio Brasileiro de Cirurgi£¿es
%D 2013
%I Col¨¦gio Brasileiro de Cirurgi?es
%X OBJETIVO: Avaliar a incid¨ºncia de f¨ªstula faringocutanea ap¨®s laringectomia total e tentar identificar os fatores preditores. M¨¦TODOS: No per¨ªodo de maio de 2005 a abril de 2010, 93 pacientes foram submetidos ¨¤ laringectomia total. Foram avaliadas as complica  es per e p¨®s-operat¨®rias e comparadas com as seguintes vari¨¢veis: sexo, estado nutricional, traqueostomia pr¨¦via, localiza  o do tumor prim¨¢rio, tipo de opera  o realizada, estadiamento de acordo com o TNM, tratamento pr¨¦vio com quimioterapia e/ou radioterapia, utiliza  o de retalhos para reconstru  o e margem cir¨²rgica. Todos os pacientes apresentavam a neoplasia em est¨¢dio avan ado segundo o TNM. RESULTADOS: 14 (15,1%) pacientes evolu¨ªram com f¨ªstula salivar no p¨®s-operat¨®rio. O tempo m¨¦dio de aparecimento da f¨ªstula salivar foi 3,5 dias, com desvio padr o de 13,7 dias. Comparando a f¨ªstula salivar com as vari¨¢veis TNM, tipo de opera  o e esvaziamento cervical, traqueostomia pr¨¦via, utiliza  o de retalho miocutaneo, r¨¢dio e quimioterapia pr¨¦-operat¨®ria e margem cir¨²rgica, n o foi observado diferen a estatisticamente significativa (p>0,05). CONCLUS O: A incid¨ºncia de f¨ªstula salivar foi 15,1% e n o foi encontrado fator preditor para sua forma  o. OBJECTIVE: To evaluate the incidence of pharyngocutaneous fistula after total laryngectomy and try to identify its predictors. METHODS: From May 2005 to April 2010, 93 patients underwent total laryngectomy. We evaluated complications during and after surgery and compared them with the following variables: gender, nutritional status, previous tracheotomy, tumor location, type of surgery, TNM staging, prior treatment with chemotherapy and/or radiotherapy, use of flaps for reconstruction and surgical margin. All patients presented with advanced neoplastic disease according to TNM. RESULTS: 14 (15.1%) patients developed postoperative salivary fistula. The mean time to onset of salivary fistula was 3.5 days, with a standard deviation of 13.7 days. Comparing salivary fistula with TNM variables, type of operation and neck dissection, prior tracheotomy, use of flap, preoperative radio and chemotherapy and surgical margin, there was no statistically significant difference (p> 0,05). CONCLUSION: The incidence of salivary fistula was 15.1% and no predictive factor for its formation was found.
%K F¨ªstula do sistema digest¨®rio
%K F¨ªstula das glandulas salivares
%K Complica  es p¨®s-operat¨®rias
%K Laringectomia
%K Neoplasias lar¨ªngeas
%K Fistula of the digestive system
%K Fistula salivary glands
%K Postoperative complications
%K Laryngectomy
%K Laryngeal neoplasms
%U http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0100-69912013000200003