Stapler closure versus manual closure in total laryngectomy for laryngeal cancer: A systematic review and meta‐analysis

Lee, Yi-Chan; Fang, Tuan‐Jen; Kuo, I‐Chun; Tsai, Yao‐Te; Hsin, Li‐Jen

doi:10.1111/coa.13702

Cited by 15 publications

(17 citation statements)

References 24 publications

(70 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Furthermore, patients undergoing stapler closure spend less time in the hospital. We report that those undergoing stapler closure spent less time in the hospital, as is supported by other studies ( 10 , 18 ). Reduced hospital time can contribute to the cost-effectiveness of the stapler.…”

Section: Discussionsupporting

confidence: 89%

“…Some authors reported a higher rate of PCF formation in the MS group, although this was not statistically significant ( 14 , 15 ). Others reported a significantly lower incidence of PCF in the SS group ( 16 , 17 ), which is supported by a recent meta-analysis ( 10 ). These variations could be explained by multiple factors, such as a small sample size, as well as patient characteristics that may impair wound healing, such as DM, smoking history, and prior irradiation.…”

Section: Discussionmentioning

confidence: 52%

“…The use of a muscle flap was significantly higher in the MS group. One of the advantages of SS is the ability to preserve the blood supply better when compared to MS, due to the repetitive trauma occurring during manual suturing techniques ( 10 ). The development of a PCF is the most common complication following TL, with its incidence reaching 65% in one study ( 11 ).…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Stapler Pharyngeal Repair Versus Conventional Suturing After Laryngectomy in Jordanian Laryngeal Cancer Patients

Al-Gargaz¹,

Mohamad²,

Eid³

et al. 2022

Med Arch

View full text Add to dashboard Cite

Background: The use of staplers in surgical repair of the pharynx after laryngectomy has gained traction in recent years, with differing results. Objective: In this study, we compare the use of stapler suturing (SS) after laryngectomy in comparison with the manual suturing (MS) technique in laryngeal cancer patients regarding pharyngocutaneous fistula (PCF) formation, operative time, blood loss, margin status, and length of hospital stay. Methods: We conducted a retrospective cohort study of laryngeal cancer patients undergoing pharyngeal repair after total laryngectomy by either a stapler or manual suturing. Demographic data, stage of disease, postoperative complications, duration of hospital stay, and operative time were collected. Results: A total of 59 laryngeal cancer patients were included, of which 22 underwent SS and 37 had MS. Our cohort was predominantly males (98%), and similar mean ages were observed across both suturing groups (60.5 vs 59.9, P = 0.83). Negative margins were more frequent with SS (100% vs 86.5%, P = 0.13) yet this difference was not statistically significant, whereas preoperative tracheostomy procedure was present more in MS patients (43.2% vs 0, P = 0.003). Lymph node involvement was higher in the manual suturing cohort, yet this difference was statistically insignificant (41.2% vs 25%, P = 0.49). The muscle flap procedure was significantly higher in the MS cohort (70.3% vs 20%, P = 0.001). In both groups, comparable PCF rates were noted (13.3% vs 10.8%) and there was no association between salvage laryngectomy and PCF occurrence in the entire cohort. For surgery details, there was no statistical difference between both groups in blood loss, hospitalization length, or oral feeding start. Only surgical time was significantly lower in the stapler cohort (277 vs 372.6 minutes, P = 0.000). Conclusion: Both suturing techniques did not show any statistically significant difference in PCF rates. However, was markedly reduced with stapler use in comparison to manual suturing. Further randomized studies with larger sample size are needed to validate the role of stapler suturing for pharyngeal repair.

show abstract

Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 52%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Stapler Pharyngeal Repair Versus Conventional Suturing After Laryngectomy in Jordanian Laryngeal Cancer Patients

Al-Gargaz¹,

Mohamad²,

Eid³

et al. 2022

Med Arch

View full text Add to dashboard Cite

show abstract

“…This closed technique significantly shortens the operation time and hospitalization [49]. Post-operative pharyngeal fistula and other complications occurring after stapling closure were shown to be comparable to, if not better than, those occurring after manual closure [48][49][50][51][52]. No study has confirmed the significant benefit of using stapling closure in salvage total laryngectomy [49].…”

Section: Reconstruction Of the Neopharynxmentioning

confidence: 99%

Total Laryngectomy: A Review of Surgical Techniques

Chotipanich

2021

Cureus

View full text Add to dashboard Cite

Since the first total laryngectomy was performed in the late 18th century, several improvements and variations in surgical techniques have been proposed for this procedure. The surgical techniques employed in total laryngectomy have not been comprehensively discussed to date. Thus, the main objective of this article was to address controversial aspects related to this procedure and compare different surgical techniques used for a total laryngectomy procedure from the beginning to the end.Although the management paradigms in laryngeal and hypopharyngeal squamous cell carcinomas have shifted to organ-preserving chemoradiotherapy protocols, total laryngectomy still plays a prominent role in the treatment of advanced and recurrent tumors. The increased incidence of complications associated with salvage total laryngectomy has driven efforts to improve the surgical techniques in various aspects of the operation. Loss of voice and impaired swallowing are the most difficult challenges to be overcome in laryngectomies, and the introduction of tracheoesophageal voice prostheses has made an enormous difference in postoperative rehabilitation and quality of life. Advancements in reconstruction techniques, tumor control, and metastatic management, such as prophylactic neck treatments and paratracheal nodal dissection (PTND), as well as the use of thyroid gland-preserving total laryngectomy in selected patients have all led to the increasing success of modern total laryngectomy. Several conclusions regarding the benchmarking of surgical techniques cannot be drawn. Issues regarding total laryngectomy are still open for discussion, and the technique will continue to require improvement in the near future.

show abstract

“…Stapler closure versus manual closure in total laryngectomy for laryngeal cancer: A systematic review and meta-analysis Dear Editor, We read with interest the systematic review and meta-analysis on stapler closure vs manual closure in total laryngectomy for laryngeal cancer. 1 The authors should be congratulated for attempting to answer this important question. However, we believe that the authors' conclusion that "the presented meta-analysis provides current evidence for the use of stapler closure in laryngeal cancer patients undergoing total laryngectomy" cannot be supported based on their meta-analysis.…”

mentioning

confidence: 99%