Stapler-Assisted Pharyngeal Closure After Total Laryngectomy: A Systematic Review and Meta-Analysis.
Journal: Oncology and therapy
Volume: 10
Issue: 1
Year of Publication:
Affiliated Institutions:
Department of Otorhinolaryngology-Head and Neck Surgery, Hospital Universitario Donostia-Biodonostia Health Research Institute, Calle Doctor Begiristain, #. CP. , Donostia-San Sebastian, Gipuzkoa-Basque Country, Spain. chiesaestomba@gmail.com.
Otorhinolaryngology-Head and Neck Surgery Department, Complexo Hospitalario Universitario A Coruña (CHUAC), , A Coruña, Galicia, Spain.
Otorhinolaryngology-Head and Neck Surgery Department, Hospital Universitario Virgen Macarena, Seville, Spain.
Department of Otolaryngology-Head and Neck Surgery, Foch Hospital, Paris Saclay University, Paris, France.
Division of Otolaryngology, University of Cape Town, Groote Schuur Hospital, Cape Town, South Africa.
Department of Otolaryngology-Head and Neck Surgery, AHEPA University Hospital, Thessaloniki, Greece.
Department of Mental and Physical Health and Preventive Medicine, "L. Vanvitelli" University, Naples, Italy.
Department of Otorhinolaryngology-Head and Neck Surgery, Hospital Universitario Donostia-Biodonostia Health Research Institute, Calle Doctor Begiristain, #. CP. , Donostia-San Sebastian, Gipuzkoa-Basque Country, Spain.
Division of Otolaryngology-Head and Neck Surgery, Centre Hospitalier de L'Université de Montréal, Montreal, Canada.
Coordinator of the International Head and Neck Scientific Group, Padua, Italy.
Abstract summary
Pharyngocutaneous fistula (PCF) remains the most frequent complication following total laryngectomy (TL). Pharyngeal closure with a surgical stapler (SAPC) has been proposed as an effective closure technique that decreases the rate of PCF, reduces surgical time, decreases the length of hospital stay, and shortens the time required before safely initiating oral feeding.This study involved a systematic review and meta-analysis of patients with laryngeal cancer who underwent TL and with subsequent stapler pharyngeal closure, in order to analyse the current literature regarding the role of SAPC after TL.The incidence of PCF in the stapler-assisted suture group (SASG) was 9.5% (95% CI 8.2-15.9%), with a mean absolute deviation of 1.12, while in the hand-suture group (HSG) group the incidence was 23.4% (95% CI 23-26.1%), with a mean absolute deviation of 5.71 (p = 0.01).SAPC may decrease the risk of PCF in patients following TL. Based on the current data, SAPC appears to shorten the surgical time and the length of hospital stay. Nevertheless, prospective randomized trials are required to validate these findings.
Authors & Co-authors:
Chiesa-Estomba Carlos M CM
Mayo-Yanez Miguel M
Palacios-García Jose M JM
Lechien Jerome R JR
Viljoen Gerrit G
Karkos Petros D PD
Barillari Maria R MR
González-García Jose A JA
Sistiaga-Suarez Jon A JA
González-Botas Jesus Herranz JH
Ayad Tareck T
Ferlito Alfio A
Study Outcome
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