Effectiveness of Recombinant Human Growth Hormone for Pharyngocutaneous Fistula Closure.
نویسندگان
چکیده
OBJECTIVES In laryngeal cancer, which comprises 25% of head and neck cancer, chemotherapy has come into prominence with the increase in organ-protective treatments. With such treatment, salvage surgery has increased following recurrence; the incidence of pharyngocutaneous fistula has also increased in both respiratory and digestive system surgery. We investigated the effects of recombinant human growth hormone on pharyngocutaneous fistula closure in Sprague-Dawley rats, based on an increase in amino acid uptake and protein synthesis for wound healing, an increase in mitogenesis, and enhancement of collagen formation by recombinant human growth hormone. METHODS This study was experimental animal study. Forty Sprague-Dawley rats were separated into two groups, and pharyngoesophagotomy was performed. The pharyngoesophagotomy was sutured with vicryl in both groups. Rats in group 1 (control group) received no treatment, while those in group 2 were administered a subcutaneous injection of recombinant human growth hormone daily. On day 14, the pharynx, larynx, and upper oesophagus were excised and examined microscopically. RESULTS Pharyngocutaneous fistula exhibited better closure macroscopically in the recombinant human growth hormone group. There was a significant difference in collagen formation and epithelisation in the recombinant human growth hormone group compared to the control group. CONCLUSION This study is believed to be the first in which the effect of recombinant human growth hormone on pharyngocutaneous fistula closure was evaluated, and the findings suggest the potential of use of growth hormone for treatment of pharyngocutaneous fistula.
منابع مشابه
روش جدید ترمیم زخم پس از لارنژکتومی توتال
Background: Total laryngectomy is the mainstay of treatment for laryngeal cancer. Fistula is one of the most common complications after total laryngectomy. In patients without risk factors such as prior radiotherapy, diabetes mellitus or chronic renal disease, the incidence of pharyngocutaneous fistula is related to wound healing and duration of operation. We have developed a new method that is...
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Presented here is a case of a pharyngocutaneous fistula which was closed primarily using a sternomastoid muscle flap, without skin coverage, thus obviating the need for a three-layered closure. Providing an intermediate cover was sufficient for the closure because the mucosal lining on the inside and the cutaneous covering on the outside grew using the muscle for support.
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OBJECTIVE Although the majority of pharyngocutaneous fistulas close spontaneously with conservative measures, 20% to 30% of patients do not respond to this approach, thereby necessitating major reconstruction with adjacent or free tissue transfers. These procedures carry considerable risk, particularly in patients with medical comorbidities or a history of prior surgery/radiation. Less invasive...
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ورودعنوان ژورنال:
- Clinical and experimental otorhinolaryngology
دوره 8 4 شماره
صفحات -
تاریخ انتشار 2015