How to Reduce Pharyngocutaneous Fistula Incidence?

Objective: To summarize the protection factors for pharyngocutaneous fistula. Data Sources: Published English-language literature. Review Methods: PubMed, Ovid, Cochrane, and Web of Science databases were systematically searched using multiple search terms 127 studies were identified. Study Selection: We included studies about the PCF risk factors (meta analysis articles), Using Vascularized flap in high risk patients, Using Stapler during Pharyngeal repair, Pharyngeal Reconstruction type, using antibiotics, using anti GERD medication, using collagen patch, Early oral feeding and type of manual pharyngeal repair . We also included some under investigated measurements. Results: 127 studies were included for this study. The results showed that early detection of tumor, Control CoMorbidities, Avoid Radiotherapy and tracheotomy if that is possible, Local control of tumor during Surgery, Using Vascularized flap such Pectoralis Muscle Flap in high risk patient, Using Stapler during Pharyngeal repair and Using Jejunal Free Flap for laryngeal Reconstruction using antibiotic, anti GERD medication and collagen patch may decrease the incidence of Pharyngocutaneous. Conclusion: We can decrease the incidence of FCF by taking some measurements preoperatively, during the surgery and postoperatively.