[en] Introduction. The pharyngocutaneous fistula (PCF) has been the most frequent complication of a total laryngectomy (TL). The salivary tube (ST) has frequently been used as part of the reconstruction treatment when a PCF has appeared, but there have been very few conclusive scientific studies addressing the prophylactic use of ST to prevent the occurrence of PCF. This study tries to evaluate whether the placement of a ST reduces the incidence of PCF after a TL and to assess the factors involved in the appearance of PCF. The study also analyses the decrease in hospital length of stay and the onset of deglutition in patients with ST versus without ST. Materials and methods used. A multicenter, randomized, controlled trial in patients who had undergone a TL between May 2021 and December 2022 was conducted. Patients were randomly assigned to the ST group and control group. The incidence of fistula, the hospital length of stay, the time of start of deglutition and the appearance of other postoperative complications were collected. The study also reviewed patient data, nutritional condition, surgical and disease characteristics. Results. Patients with ST presented 30% of PCF versus the 42.2% in patients without ST. However, there was not a statistically significant difference (p = 0.243). The average length of stay in ST patients was 23 ± 10,71 days and the start of deglutition was 17,6 ± 12,84 days. In patients without ST, the average length of stay was 23,4 ± 12,79 days and the start of deglutition was 19,6 ± 13,24 days. There was not a statistically significant decrease of hospital length of stay (p= 0,887) nor an earlier onset of deglutition (p = 0,496) between these two groups. Conclusion. According to the results, there was a decrease in the percentage of PCF and an early onset in the deglutition in the ST patients compared to those in whom the tube had not been used, however, this decrease was not statistically significant.

[gl] Introdución. A fístula faringocutánea (FFC) foi a complicación máis frecuente da larinxectomía total (LT). O tubo de derivación salivar (TDS) foi frecuentemente utilizado como parte do tratamento de reconstrución cando aparecía unha FFC, pero hai moi poucos estudos científicos concluíntes que aborden o uso profiláctico do TDS para previr a aparición de FFC. Este estudo trata de avaliar se a colocación do TDS reduce a incidencia de FFC despois da LT e analizar os factores implicados na aparición de FFC. O estudo tamén analiza a redución da estancia hospitalaria e o inicio da deglutición en pacientes con TDS fronte a sen TDS. Metodoloxía. Realizouse un ensaio multicéntrico, aleatorizado e controlado en pacientes sometidos a LT entre maio de 2021 e decembro de 2022. Os pacientes foron asignados aleatoriamente ao grupo de TDS e ao grupo de control. Recolléronse a incidencia de FFC, a duración da estancia hospitalaria, o inicio da deglutición e a aparición doutras complicacións postoperatorias. O estudo tamén revisou os datos dos pacientes, o estado nutricional e as características cirúrxicas e da enfermidade. Resultados. Os pacientes con TDS presentaron un 30% de FFC fronte ao 42.2% nos pacientes sen TDS. Non obstante, non houbo unha diferenza estatisticamente significativa (p = 0.243). A estancia hospitalaria media nos pacientes con TDS foi de 23 ± 10,71 días e o inicio da deglutición de 17,6 ± 12,84 días. Nos pacientes sen TDS, a estancia media foi de 23,4 ± 12,79 días e o inicio da deglutición de 19,6 ± 13,24 días. Non houbo unha diminución estatisticamente significativa na duración da estancia hospitalaria (p = 0,887) nin no inicio da deglutición (p = 0,496) entre os dous grupos. Conclusión. Segundo os resultados, houbo unha diminución no porcentaxe de FFC e un inicio temperán da deglutición nos pacientes con TDS en comparación cos que non utilizaron o tubo, con todo, esta diminución non foi estatisticamente significativa.