Laryngectomy Clinical Trial
Official title:
Effect of Cervical Epidural Analgesia on the Occurrence of Pharyngocutaneous Fistula Following Salvage Laryngectomy and Reconstruction With Pectoralis Major Myocutaneous Flap
Verified date | February 2019 |
Source | Assiut University |
Contact | n/a |
Is FDA regulated | No |
Health authority | |
Study type | Interventional |
Pharyngocutaneous fistula (PCF) is the most commonly reported postoperative complication in
total laryngectomy patients. PCF significantly increases morbidity, length of
hospitalization, and cost of care, in addition to delaying the beginning of adjuvant therapy.
The reported incidence of PCF ranges from 3% to 65%.The increased use of radiation in the
primary management of laryngeal carcinoma has resulted in an increase in the PCF formation
after salvage laryngectomy (STL).
Previously reported risk factors for PCF development include preoperative radiotherapy, tumor
stage, concomitant neck dissection, prior need for tracheotomy, hypoalbuminemia and anemia.
Among surgical options, the pectoralis major myofascial flap has been proposed to cover the
pharyngeal closure, to interpose non-irradiated tissue between the neopharynx and the skin
during STL. Nonetheless, the efficacy of this approach is not fully established.Epidural
anesthesia improves the blood supply due to its vasodilating effect. The aim of the study is
to evaluate the effect of perioperative cervical epidural analgesia on the occurrence of
pharyngocutaneous fistula following salvage laryngectomy and reconstruction with pectoralis
major myocutaneous flap.
Status | Recruiting |
Enrollment | 46 |
Est. completion date | December 10, 2019 |
Est. primary completion date | November 2019 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 18 Years and older |
Eligibility |
Inclusion Criteria: - Patients who failed treatment with radiotherapy for laryngeal cancer Exclusion Criteria: 1. Infection at the site of flap 2. Primary laryngectomy without radiotheraapy |
Country | Name | City | State |
---|---|---|---|
Egypt | Diab | Assiut | Assuit |
Lead Sponsor | Collaborator |
---|---|
Assiut University |
Egypt,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | pharyngocutaneous fistula following salvage laryngectomy and reconstruction with pectoralis major myocutaneous flap | 2 weeks postoperatively | ||
Secondary | Pain intensity measured by visual analogue scale (VAS) | 0 h (immediately postoperative), 2h, 6h, 12h, 24h, 48h (postoperatively |
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