Role of a two-step suture in the prevention of postoperative transoral salivary fistulas during reconstruction of the oral cavity

Publication date: Available online 24 January 2019

Source: British Journal of Oral and Maxillofacial Surgery

Author(s): Z.-H. Ren, K. Wu, Y. Wang, Z.-W. Tian, J.-Z. Hu

Abstract

Transoral salivary fistulas are one of the most serious postoperative complications after operations for oral cancer, and we propose a new, two-step suture method to avoid them. From January 2005 to September 2017, 240 patients were recruited at the Shanghai Ninth People's Hospital and divided into experimental (n = 89) or control (n = 151) groups. The experimental group was treated by a two-step suture technique, while the control group had conventional sutures. Statistical differences were assessed using the chi squared and t tests, as appropriate. Only two patients developed transoral salivary fistulas in the experimental group, while in the control group there were 14 (9%). The incidence of fistulas in the experimental group was significantly lower than that in the control group (p = 0.035). Regression analysis showed that there was a significant correlation between the groups and the incidence of salivary fistulas (p = 0.032). The two-step suture technique is safe, effective, and easy to learn, and could reduce the incidence of postoperative salivary fistulas.

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