Stapler Versus Manual Suturing for Pharyngeal Closure in Total Laryngectomy

Area of Science:

• Otolaryngology
• Surgical Oncology
• Medical Devices

Background:

• Laryngeal carcinoma presents a significant global health challenge.
• Total laryngectomy is a common surgical intervention for advanced laryngeal cancer.
• Comparing surgical techniques is crucial for optimizing patient outcomes.

Purpose of the Study:

• To compare the outcomes of stapler versus conventional suturing in total laryngectomy.
• To evaluate the efficacy and safety of stapler use in primary and salvage laryngectomy procedures.
• To identify differences in complication rates, operative time, and hospital stay.

Main Methods:

• Retrospective study of 91 patients undergoing total laryngectomy (primary or salvage) between 2015-2022.
• Patients were categorized into four groups based on surgical approach (primary/salvage) and closure method (stapler/conventional suturing).
• Exclusion criteria included multiple comorbidities and need for flap reconstruction.

Main Results:

• Stapler group showed a lower pharyngocutaneous fistula rate (6.7% primary, 12.5% salvage) compared to conventional suturing (19% primary, 25% salvage).
• Hospital stay was significantly shorter with stapler use (6 days primary, 8.8 days salvage) versus conventional suturing (11.4 days primary, 13.1 days salvage).
• Stapler use demonstrated significant advantages in operative time and earlier initiation of oral feeding.

Conclusions:

• Stapler use in total laryngectomy is a simple, fast, and effective technique.
• It provides tension-free, watertight closure with improved hemostasis and reduced surgical field contamination.
• The stapler method offers superior outcomes compared to manual suturing in total laryngectomy.