Pharyngocutaneous fistula after total laryngectomy: Less common with mechanical stapler closure.

Abstract

OBJECTIVES:

The aim of the study was to compare the incidences of pharyngocutaneous fistula after total laryngectomy between patients who underwent manual and mechanical suturing for pharyngoesophageal closure.

METHODS:

In a retrospective and prospective nonrandomized clinical study conducted at a single tertiary medical center between May 2002 and April 2009, we compared the incidence of pharyngocutaneous salivary fistula between two groups of patients after total laryngectomy. Sixty-one consecutive patients who underwent mechanical suturing with a 60-mm linear stapler (group A) were prospectively enrolled, and 121 patients who had undergone manual suturing (group B) were retrospectively reviewed.

RESULTS:

The groups were similar in terms of age, gender, comorbidities, TNM (tumor, node, metastasis) stage, and laryngeal tumor extension. The incidence of pharyngocutaneous salivary fistula was 4.9% in group A and 19.8% in group B (p = 0.014).

CONCLUSIONS:

Mechanical stapler closure of the pharynx after total laryngectomy was associated with a significant reduction in the incidence of pharyngocutaneous fistula compared with manual suture in selected cases.

• Authors: Caglar Calli, Ercan Pinar, Semih Oncel
• Journal: The Annals of otology, rhinology, and laryngology (Ann Otol Rhinol Laryngol) Vol. 120 Issue 5 Pg. 339-44 (May 2011) ISSN: 0003-4894 [Print] United States
• PMID: 21675591 (Publication Type: Clinical Trial, Comparative Study, Journal Article)

Topics

• Carcinoma, Squamous Cell (surgery)
• Cutaneous Fistula (etiology, surgery)
• Equipment Design
• Female
• Humans
• Laryngeal Neoplasms (surgery)
• Laryngectomy (adverse effects)
• Male
• Middle Aged
• Otorhinolaryngologic Surgical Procedures (instrumentation)
• Pharyngeal Diseases (etiology, surgery)
• Respiratory Tract Fistula (etiology, surgery)
• Surgical Staplers
• Suture Techniques (instrumentation)
• Treatment Outcome