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Stapled closed technique for laryngectomy and pharyngeal repair

Published online by Cambridge University Press:  08 March 2017

F Ahsan ,
K W Ah-See  and
A Hussain
F Ahsan*
Affiliation:
Department of Otolaryngology and Head and Neck Surgery, Grampian University Hospitals, Aberdeen Royal Infirmary, Scotland, UK
K W Ah-See
Affiliation:
Department of Otolaryngology and Head and Neck Surgery, Grampian University Hospitals, Aberdeen Royal Infirmary, Scotland, UK
A Hussain
Affiliation:
Department of Otolaryngology and Head and Neck Surgery, Grampian University Hospitals, Aberdeen Royal Infirmary, Scotland, UK
*
Address for correspondence: Mr F Ahsan, 3 Bervie Drive, Murieston, Livingston EH54 9HA, Scotland, UK. E-mail: [email protected]
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Abstract

Background and aims:

Total laryngectomy is a recognised treatment for advanced laryngeal carcinoma. Traditionally, pharyngeal repair is performed with layered sutures. We describe our experience with a technique of closed pharyngoplasty using a linear stapler device.

Material and methods:

Ten total laryngectomies were performed from July 2002 to July 2004, using an Ethicon TLC 75 linear stapler for pharyngeal closure. Data collected included age, sex, staging, endoscopic assessment, surgical margins and post-operative course (including complications and swallowing).

Results:

Patients comprised eight men and two women. The mean age was 55.4 years. Six patients had stage T4 endolaryngeal carcinoma and four had stage T3. Four patients underwent pre-operative radiotherapy. Clear surgical margins were achieved in all patients. One patient developed a pharyngocutaneous fistula. Patients resumed oral intake at 48 hours, or at 72 hours if they had undergone pre-operative radiotherapy. Patients' mean hospital stay was seven days.

Conclusion:

This stapled closed technique for pharyngoplasty is efficient and eliminates the risk of wound contamination, thus theoretically reducing the risk of tumour seeding. In addition, we were able to commence patients on oral fluids at a mean of 48 hours after surgery. The mean hospital stay was seven days. We recommend this technique as an alternative for repairing the pharynx in patients undergoing total laryngectomy for endolaryngeal carcinoma.

Keywords

Laryngeal NeoplasmsLaryngectomySurgical Staples
Type
Short Communication
Information
The Journal of Laryngology & Otology , Volume 122 , Issue 11 , November 2008 , pp. 1245 - 1248
Copyright
Copyright © JLO (1984) Limited 2008

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Footnotes

Presented at the International Federation of Oto-Rhino-Laryngological Society conference, 25–30 June 2005, Rome, Italy.

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