Results of Platelet-Rich Fibrin Application in Pharyngeal Reconstruction After a Total Laryngectomy.

Autor: Başkadem Yilmazer A; Prof Dr Cemil Tascıoglu Hospital, Department of Otorhinolaryngology, University of Saglik Bilimleri, Istanbul, Turkey., Aksungur E; Prof Dr Cemil Tascıoglu Hospital, Department of Otorhinolaryngology, University of Saglik Bilimleri, Istanbul, Turkey., Çelik C; Prof Dr Cemil Tascıoglu Hospital, Department of Otorhinolaryngology, University of Saglik Bilimleri, Istanbul, Turkey., Bayram AA; Prof Dr Cemil Tascıoglu Hospital, Department of Otorhinolaryngology, University of Saglik Bilimleri, Istanbul, Turkey., Turgut H; Prof Dr Cemil Tascıoglu Hospital, Department of Otorhinolaryngology, University of Saglik Bilimleri, Istanbul, Turkey., Dinç ME; Prof Dr Cemil Tascıoglu Hospital, Department of Otorhinolaryngology, University of Saglik Bilimleri, Istanbul, Turkey., Göker AE; Prof Dr Cemil Tascıoglu Hospital, Department of Otorhinolaryngology, University of Saglik Bilimleri, Istanbul, Turkey., Uyar Y; Prof Dr Cemil Tascıoglu Hospital, Department of Otorhinolaryngology, University of Saglik Bilimleri, Istanbul, Turkey.
Jazyk: angličtina
Zdroj: Clinical otolaryngology : official journal of ENT-UK ; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery [Clin Otolaryngol] 2025 Jan; Vol. 50 (1), pp. 122-127. Date of Electronic Publication: 2024 Oct 19.
DOI: 10.1111/coa.14247
Abstrakt: Introduction: Pharyngocutaneous fistula (PCF) is one of the most challenging complications observed after a total laryngectomy. Since the biochemical components of platelet-rich fibrin (PRF) have well-known synergistic effects on the healing processes, this study aimed to demonstrate the contribution of PRF application to pharyngeal healing in patients undergoing a total laryngectomy for laryngeal cancer.
Methods: The study compared patients who underwent a total laryngectomy due to laryngeal squamous cell carcinoma and had a PRF membrane placed during the pharyngoesophageal closure with those who did not. There were two groups: PRF-positive and PRF-negative. In the PRF-positive group, after the completion of the total laryngectomy and moving on to the pharyngoesophageal closure stage, along the suture line, PRF material is laid in two pieces in a T-shape and secured with several sutures. No PRF application was done in the PRF-negative group. Pharyngeal healing steps (nasogastric feeding, oral feeding, development of a fistula), haemoglobin and albumin values, tumour involvement areas, time to oral intake and length of hospital stay were recorded for all patients.
Results: This study reviewed the records of 33 patients who underwent pharyngoesophageal closure with PRF application after a total laryngectomy (PRF-positive group) and 35 patients without PRF application (PRF-negative group). When comparing patients in terms of developing a PCF, 6% (n = 2) of patients in the PRF-positive group and 25.7% (n = 9) in the PRF-negative group developed a fistula. This ratio was significantly higher in the PRF-negative group (p = 0.027).
Conclusion: The application of PRF in pharyngoesophageal reconstruction after a total laryngectomy may strengthen wound healing and reduce the risk of PCF development.
Trial Registration: This study is a retrospective designed study; therefore, there is no clinical trial registration.
(© 2024 The Author(s). Clinical Otolaryngology published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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