Volume 41, Issue 12 pp. 4121-4127
ORIGINAL ARTICLE

Factors predisposing to the development of orocutaneous fistula following surgery for oral cancer: Experience from a tertiary cancer center

Farhana Girkar MDS

Farhana Girkar MDS

Department of Head & Neck Oncology, Tata Memorial Hospital, Mumbai, India

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Shivakumar Thiagarajan MS, DNB

Corresponding Author

Shivakumar Thiagarajan MS, DNB

Department of Head & Neck Oncology, Tata Memorial Hospital, Mumbai, India

Correspondence

Shivakumar Thiagarajan, Department of Head & Neck Oncology, Tata Memorial Hospital, Parel, Mumbai 400012, India.

Email: [email protected]

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Akshat Malik MCh

Akshat Malik MCh

Department of Head & Neck Oncology, Tata Memorial Hospital, Mumbai, India

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Shikhar Sawhney MS

Shikhar Sawhney MS

Department of Head & Neck Oncology, Tata Memorial Hospital, Mumbai, India

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Anuja Deshmukh MCh

Anuja Deshmukh MCh

Department of Head & Neck Oncology, Tata Memorial Hospital, Mumbai, India

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Devendra Chaukar MS, DNB

Devendra Chaukar MS, DNB

Department of Head & Neck Oncology, Tata Memorial Hospital, Mumbai, India

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Anil D'Cruz MS, DNB

Anil D'Cruz MS, DNB

Department of Head & Neck Oncology, Tata Memorial Hospital, Mumbai, India

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First published: 09 September 2019
Citations: 20

Abstract

Background

Orocutaneous fistula (OCF) is one of the frequently encountered postoperative complications following surgery for oral cancer, leading to prolonged hospital stay and delay in the initiation of adjuvant therapy.

Methods

We included all patients with oral cancer operated between January 2016 to December 2017 and at risk to develop an OCF. We assessed the incidence of OCF, its management, and factors predisposing to its development.

Results

Of 587 eligible patients, 9% developed OCF. On univariate and multivariate analysis, patients undergoing bilateral neck dissection or with surgical site infection (SSI) (P < .001) were at maximum risk. On univariate analysis, the incidence was higher following resections for tongue-floor of mouth sub site (P = .002), irrespective of the type of flap used for reconstruction. Majority (57%) required surgical intervention for management.

Conclusion

The presence of SSI and performing bilateral neck dissection posed the maximum risk for developing OCF in patients undergoing surgery for oral cancer.

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