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Pharyngeal closure after a total laryngectomy: mechanical versus manual technique

Published online by Cambridge University Press:  29 July 2020

A Sansa-Perna ,
M Casasayas-Plass ,
C Rovira-Martínez ,
M López-Vilas ,
J García-Lorenzo ,
M Quer-Agusti  and
X León-Vintró
A Sansa-Perna*
Affiliation:
Otorhinolaryngology Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Spain
M Casasayas-Plass
Affiliation:
Otorhinolaryngology Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Spain
C Rovira-Martínez
Affiliation:
Otorhinolaryngology Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Spain
M López-Vilas
Affiliation:
Otorhinolaryngology Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Spain
J García-Lorenzo
Affiliation:
Otorhinolaryngology Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Spain
M Quer-Agusti
Affiliation:
Otorhinolaryngology Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Spain
X León-Vintró
Affiliation:
Otorhinolaryngology Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Spain Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (‘CIBER-BBN’), Madrid, Spain
*
Author for correspondence: Dr Aina Sansa-Perna, Otorhinolaryngology Department, Hospital de la Santa Creu i Sant Pau, C/ Mas Casanovas, 90, 08041Barcelona, Spain E-mail: asansa@santpau.cat Fax: +34 93 5565604
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Abstract

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.

Keywords

LaryngectomySuture TechniquesSurgical StaplingCutaneous FistulaSurgical Margins
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 134 , Issue 7 , July 2020 , pp. 626 - 631
Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

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Footnotes

Dr A Sansa-Perna takes responsibility for the integrity of the content of the paper

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