Hostname: page-component-78c5997874-ndw9j Total loading time: 0 Render date: 2024-11-05T01:42:55.471Z Has data issue: false hasContentIssue false
  • English
  • Français

Pharyngeal closure after a total laryngectomy: mechanical versus manual technique

Published online by Cambridge University Press:  29 July 2020

A Sansa-Perna ,
M Casasayas-Plass ,
C Rovira-Martínez ,
M López-Vilas ,
J García-Lorenzo ,
M Quer-Agusti  and
X León-Vintró
A Sansa-Perna*
Affiliation:
Otorhinolaryngology Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Spain
M Casasayas-Plass
Affiliation:
Otorhinolaryngology Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Spain
C Rovira-Martínez
Affiliation:
Otorhinolaryngology Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Spain
M López-Vilas
Affiliation:
Otorhinolaryngology Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Spain
J García-Lorenzo
Affiliation:
Otorhinolaryngology Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Spain
M Quer-Agusti
Affiliation:
Otorhinolaryngology Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Spain
X León-Vintró
Affiliation:
Otorhinolaryngology Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Spain Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (‘CIBER-BBN’), Madrid, Spain
*
Author for correspondence: Dr Aina Sansa-Perna, Otorhinolaryngology Department, Hospital de la Santa Creu i Sant Pau, C/ Mas Casanovas, 90, 08041Barcelona, Spain E-mail: [email protected] Fax: +34 93 5565604
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective

To verify the main advantages and drawbacks of mechanical suturing for pharyngeal closure after total laryngectomy versus a manual suturing technique.

Methods

A retrospective review was carried out of 126 total laryngectomies performed between 2008 and 2018. Manual closure was performed in 80 cases (63.5 per cent) and mechanical suturing was performed in 46 cases (36.5 per cent).

Results

Mechanical suturing was used significantly more frequently in patients with: glottic tumours (p = 0.008), less local tumour extension (p = 0.017) and less pre-operative morbidity (p = 0.014). There were no significant differences in the incidence of pharyngocutaneous fistula between the manual suture group (16.3 per cent) and the mechanical suture group (13.0 per cent) (p = 0.628). None of the patients treated with mechanical suturing had positive surgical margins. Cancer-specific survival for the mechanical suture group was higher than that for the manual suture group (p = 0.009).

Conclusion

Mechanical suturing of the pharynx after total laryngectomy is an oncologically safe technique if used in suitable cases.

Keywords

LaryngectomySuture TechniquesSurgical StaplingCutaneous FistulaSurgical Margins
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 134 , Issue 7 , July 2020 , pp. 626 - 631
Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Dr A Sansa-Perna takes responsibility for the integrity of the content of the paper

References

Hoehn, JG, Payne, WS. Resection of pharyngoesophageal diverticulum using stapling device. Mayo Clin Proc 1969;44:738–41Google ScholarPubMed
Paches, AI, Ogoltsova, ES, Petrova, NP, Tsybyrne, GA. Mechanical suturing in laryngectomy [in Russian]. Vestn Akad Med Nauk SSSR 1972;27:43–6Google Scholar
Lukyanchenko, AG, Knowles, JEA. Suturing of a laryngeal defect in laryngectomy [in Russian]. Vestn Otorhinolaryngol 1971;33:29–31Google Scholar
Sofferman, RA, Voronetsky, I. Use of the linear stapler for pharyngoesophageal closure after total laryngectomy. Laryngoscope 2000;110:1406–9CrossRefGoogle ScholarPubMed
Agrawal, A, Schuller, DE. Closed laryngectomy using the automatic linear stapling device. Laryngoscope 2000;110:1402–5CrossRefGoogle ScholarPubMed
Altissimi, G, Frenguelli, A. Linear stapler closure of the pharynx during total laryngectomy: a 15-year experience (from closed technique to semi-closed technique). Acta Otorhinolaryngol Ital 2007;27:118–22Google Scholar
Zhang, X, Liu, Z, Li, Q, Liu, X, Li, H, Liu, W et al. Using a linear stapler for pharyngeal closure in total laryngectomy. Eur Arch Otorhinolaryngol 2013;270:1467–71CrossRefGoogle ScholarPubMed
Santaolalla Montoya, F, Ruiz de Galarreta, JC, Sánchez del Rey, A, Martínez Ibargüen, A, Zabala López de Maturana, A. Comparative study of the use of manual and mechanical suturing in the closure of the mucosal defect in total laryngectomy [in Spanish]. Acta Otorrinolaringol Esp 2002;53:343–50CrossRefGoogle Scholar
Manola, M, D'Angelo, L, Longo, F, De Vivo, S, Villano, S, De Maria, G et al. The stapler in total laryngectomy with closed technique [in Italian]. Tumori 2003;89:260–2Google Scholar
Bedrin, L, Ginsburg, G, Horowitz, Z, Talmi, YP. 25-year experience of using a linear stapler in laryngectomy. Head Neck 2005;27:1073–9CrossRefGoogle ScholarPubMed
Ahsan, F, Ah-See, KW, Hussain, A. Stapled closed technique for laryngectomy and pharyngeal repair. J Laryngol Otol 2008;122:1245–8CrossRefGoogle ScholarPubMed
Gonçalves, AJ, de Souza, JA Jr, Menezes, MB, Kavabata, NK, Suehara, AB, Lehn, CN. Pharyngocutaneous fistulae following total laryngectomy comparison between manual and mechanical sutures. Eur Arch Otorhinolaryngol 2009;266:1793–8CrossRefGoogle ScholarPubMed
Calli, C, Pinar, E, Oncel, S. Pharyngocutaneous fistula after total laryngectomy: less common with mechanical stapler closure. Ann Otol Rhinol Laryngol 2011;120:339–44CrossRefGoogle ScholarPubMed
Dedivitis, RA, Aires, FT, Pfuetzenreiter, EG Jr, Castro, MA, Guimarães, AV. Stapler suture of the pharynx after total laryngectomy. Acta Otorhinolaryngol Ital 2014;34:94–8Google ScholarPubMed
Benson, EM, Hirata, RM, Thompson, CB, Ha, PK, Fakhry, C, Saunders, JR et al. . Pharyngocutaneous fistula after total laryngectomy: a single-institution experience, 2001–2012. Am J Otolaryngol 2015;36:24–31CrossRefGoogle ScholarPubMed
Beswick, DM, Damrose, EJ. Primary tracheoesophageal puncture and cricopharyngeal myotomy in stapler-assisted total laryngectomy. J Laryngol Otol 2016;130:686–90CrossRefGoogle ScholarPubMed
Ismi, O, Unal, M, Vayisoglu, Y, Yesilova, M, Helvaci, I, Gorur, K et al. Stapler esophageal closure during total laryngectomy. J Craniofac Surg 2017;28:e35–40CrossRefGoogle ScholarPubMed
Paddle, P, Husain, I, McHugh, L, Franco, R Jr. Outcomes of mechanical stapling for postlaryngectomy open pharyngotomy closure. Laryngoscope 2017;127:605–10CrossRefGoogle ScholarPubMed
Aires, FT, Dedivitis, RA, Castro, MA, Bernardo, WM, Cernea, CR, Brandão, LG. Efficacy of stapler pharyngeal closure after total laryngectomy: a systematic review. Head Neck 2014;36:739–42CrossRefGoogle ScholarPubMed
Leahy, KP, Tufano, RP. Primary tracheoesophageal puncture in stapler-assisted total laryngectomy. ORL J Otorhinolaryngol Relat Spec 2010;72:124–6CrossRefGoogle ScholarPubMed
Supplementary material: File

Sansa-Perna et al. supplementary material

Table S1

Download Sansa-Perna et al. supplementary material(File)
File 23.9 KB