Stapler Assisted Total Laryngectomy: A Prospective Randomized Clinical Study

Indian J Otolaryngol Head Neck Surg. 2022 Oct;74(Suppl 2):2205-2213. doi: 10.1007/s12070-020-02086-3. Epub 2020 Aug 27.

Abstract

Closure of the pharyngeal defect after total laryngectomy had been traditionally performed with manual suturing techniques that invert the mucosal edge this technique though effective, yet it is time-consuming. Recently the use of stapling devices to successfully close the pharyngeal defect after total laryngectomy has been advocated to shorten the operative time, especially in the high-risk cancer patients where a prolonged operative time is not preferred. The present study aimed at comparing stapler assisted total laryngectomy to suture closure total laryngectomy in a prospective randomized manner. This is a prospective clinical study conducted on 60 patients undergoing total laryngectomy at Alexandria Main University Hospital, Egypt. Patients with tumor extension to the hypopharynx or base of the tongue were excluded from the study. The surgical time is reduced with shorter hospital stays and no increase in postoperative complications rate. The use of the stapler is technically easy to perform and as equally as effective as the traditional neopharyngeal suturing techniques in patients undergoing total laryngectomy.

Keywords: Closure; Neopharynx; Operative time; Pharyngocutaneous fistula; Stapler; Total laryngectomy.