Surgical prevention of pharyngocutaneous fistula in salvage total laryngectomy: a systematic review and network meta-analysis.
Eur Arch Otorhinolaryngol
; 279(12): 5839-5849, 2022 Dec.
Article
em En
| MEDLINE
| ID: mdl-35731297
ABSTRACT
PURPOSE:
To compare the efficacy of different reconstructive techniques in preventing pharyngocutaneous fistula (PCF) after salvage total laryngectomy (STL).METHODS:
An arm-based network analysis was conducted using a Bayesian hierarchical model according to the PRISMA-NMA guidelines.RESULTS:
A total of 1694 patients with a median age of 64 years (n = 1569, 95% CI 62-66 years) were included. If compared to primary pharyngeal closure alone, only a pedicled flap onlay (PFO) showed a statistically significant reduction in PCF rate (OR 0.35, CI 0.20-0.61). PFO seemed to perform better than other treatments according to the rank probabilities test (39.9% chance of ranking first).CONCLUSIONS:
A pedicled flap placed with an overlay technique might be preferred over a patch reconstruction to prevent PCF after STL.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Doenças Faríngeas
/
Neoplasias Laríngeas
/
Fístula Cutânea
Tipo de estudo:
Etiology_studies
/
Guideline
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
/
Systematic_reviews
Limite:
Humans
/
Middle aged
Idioma:
En
Ano de publicação:
2022
Tipo de documento:
Article