KHẢO SÁT CÁC YẾU TỐ LIÊN QUAN CỦA DÒ HỌNG RA DA SAU CẮT THANH QUẢN TOÀN PHẦN

Abstract

Introduction: Pharyngocutaneous fistula (PCF) is a frequent postoperative complication following total laryngectomy, with an incidence ranging from 13.7% to 39.1%. This complication markedly affects patient quality of life, prolongs hospitalization, and increases healthcare costs. Identifying and evaluating risk factors for PCF are essential to enhance prevention, enable early detection, and optimize management outcomes. Objective: To investigate clinical and laboratory risk factors associated with pharyngocutaneous fistula in patients undergoing total laryngectomy. Patients and Methods: This retrospective study included 122 patients with laryngeal cancer who underwent total laryngectomy at the University Medical Center Ho Chi Minh City between January 2021 and January 2025. Complete clinical, imaging, and laboratory data were analyzed. Associations between PCF and potential risk factors—demographic, comorbid, oncologic, surgical, and biochemical—were assessed using appropriate statistical tests. Results: Among 122 patients, 28 developed PCF, corresponding to an incidence of 23%. No significant associations were observed with age, body mass index, smoking, alcohol consumption, hypertension, diabetes mellitus, chronic obstructive pulmonary disease, radiotherapy, tracheostomy, TNM stage, surgical technique, or perioperative hemoglobin levels (p > 0.05). In contrast, postoperative white blood cell count (p < 0.001), postoperative C-reactive protein (p < 0.001), and preoperative serum albumin < 35 g/L (p = 0.0076) were significantly associated with PCF occurrence. Conclusion: Low preoperative albumin level, elevated postoperative white blood cell count, and increased postoperative C-reactive protein are key laboratory predictors of pharyngocutaneous fistula after total laryngectomy. Close perioperative monitoring of these indices may facilitate early identification, timely intervention, and contribute to reducing the incidence of this serious postoperative complication.