Pharyngeal closure after a total laryngectomy: mechanical versus manual technique

ObjectiveTo verify the main advantages and drawbacks of mechanical suturing for pharyngeal closure after total laryngectomy versus a manual suturing technique.MethodsA retrospective review was carried out of 126 total laryngectomies performed between 2008 and 2018. Manual closure was performed in 80...

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Bibliographic Details
Published in:Journal of laryngology and otology 2020-07, Vol.134 (7), p.626-631
Main Authors: Sansa-Perna, A, Casasayas-Plass, M, Rovira-Martínez, C, López-Vilas, M, García-Lorenzo, J, Quer-Agusti, M, León-Vintró, X
Format: Article
Language:English
Subjects:
Cartilage
Epiglottis
Fistula
Larynx
Main Articles
Medical personnel
Morbidity
Pharynx
Prostheses
Radiation therapy
Surgery
Surgical techniques
Sutures
Thyroid gland
Tumors
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Summary:ObjectiveTo verify the main advantages and drawbacks of mechanical suturing for pharyngeal closure after total laryngectomy versus a manual suturing technique.MethodsA 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).ResultsMechanical 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).ConclusionMechanical suturing of the pharynx after total laryngectomy is an oncologically safe technique if used in suitable cases.
ISSN:0022-2151
1748-5460
DOI:10.1017/S0022215120001371