Defect repair with fibrin glue/polyglycolic acid after endoscopic laryngopharyngeal cancer resection

Laryngoscope. 2020 Jul;130(7):1740-1745. doi: 10.1002/lary.28265. Epub 2019 Aug 28.

Abstract

Objectives/hypothesis: In 2013, we introduced a modified technique for mucosal/muscle layer defect coverage with fibrin glue and polyglycolic acid (PGA) sheets (mMCFP technique) in patients undergoing endoscopic transoral surgeries for laryngopharyngeal cancers. This technique allows easy and convenient coverage of the wound surface, even when it involves the laryngopharyngeal lumen. To our knowledge, use of the MCFP technique for coverage of postoperative mucosal and/or muscle layer defects involving the laryngopharyngeal lumen has not been reported. The aim of the present study was to retrospectively evaluate the safety of our mMCFP technique used simultaneously with endoscopic transoral resection of Tis, T1, T2, and select T3 pharyngeal and supraglottic cancers.

Study design: A single centre retrospective study.

Methods: Between June 2013 and February 2019, 102 patients underwent simultaneous end-flexible-rigidscopic transoral surgery and wound coverage using our mMCFP technique. All patients required mucosal and/or muscle layer resection. For all patients, we recorded the incidence of postoperative complications and the time period for which the PGA sheets could be observed after surgery.

Results: In 41%, 35%, and 8% patients, the PGA sheets could be observed on the wound surface for 2, 3, and 4 weeks, respectively. Other than postoperative bleeding in two patients (2%), no postoperative complications were recorded.

Conclusions: The findings of this study suggest that our mMCFP technique is a safe and simple method for the repair of mucosal and/or muscle layer defects after endoscopic transoral surgery for laryngopharyngeal cancers.

Level of evidence: 4 Laryngoscope, 130:1740-1745, 2020.

Keywords: Supraglottic cancer; fibrin glue; pharyngeal cancer; polyglycolic acid; wound repair.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Fibrin Tissue Adhesive / pharmacology*
  • Follow-Up Studies
  • Humans
  • Laryngeal Neoplasms / diagnosis
  • Laryngeal Neoplasms / surgery*
  • Male
  • Middle Aged
  • Mouth
  • Natural Orifice Endoscopic Surgery / adverse effects*
  • Neoplasm Staging
  • Polyglycolic Acid / pharmacology*
  • Postoperative Complications / therapy*
  • Retrospective Studies
  • Tissue Adhesives / pharmacology
  • Treatment Outcome
  • Wound Closure Techniques*

Substances

  • Fibrin Tissue Adhesive
  • Tissue Adhesives
  • Polyglycolic Acid