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Risk Factors of Morton et al for a Pharyngocutaneous Fistula Following Laryngectomy

Description

Morton et al identified risk factors for a pharyngocutaneous fistula in patients who have undergone a laryngectomy. These can help to identify a patient who may require more aggressive management. The author are from Auckland Hospital in New Zealand.


Patient selection: status post laryngectomy for squamous cell carcinoma of larynx or hypopharynx

Outcome: pharyngocutaneous fistula

 

Risk factors for fistula formation:

(1) extended laryngectomy (pharyngolaryngectomy)

(2) postoperative day 1 drain fluid amylase > 4,000 IU/L

 

If both factors are present then the performance characteristics are: sensitivity 83%, specificity 94%, and negative predictive value of 98%.


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