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1 results

  • Pharyngeal closure after a total laryngectomy: mechanical versus manual technique

  • A Sansa-Perna, M Casasayas-Plass, C Rovira-Martínez, M López-Vilas, J García-Lorenzo, M Quer-Agusti, X León-Vintró
  • Journal:
    The Journal of Laryngology & Otology / Volume 134 / Issue 7 / July 2020
    Published online by Cambridge University Press:
    29 July 2020, pp. 626-631
    Print publication:
    July 2020
  • 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.