Pharyngocutaneous Fistula; Surgical Stapler; Total Laryngectomy; Oncology
Abstract :
[en] [en] INTRODUCTION: Pharyngocutaneous fistula (PCF) remains the most frequent complication following total laryngectomy (TL). Pharyngeal closure with a surgical stapler (SAPC) has been proposed as an effective closure technique that decreases the rate of PCF, reduces surgical time, decreases the length of hospital stay, and shortens the time required before safely initiating oral feeding.
METHODS: This study involved a systematic review and meta-analysis of patients with laryngeal cancer who underwent TL and with subsequent stapler pharyngeal closure, in order to analyse the current literature regarding the role of SAPC after TL.
RESULTS: The incidence of PCF in the stapler-assisted suture group (SASG) was 9.5% (95% CI 8.2-15.9%), with a mean absolute deviation of 1.12, while in the hand-suture group (HSG) group the incidence was 23.4% (95% CI 23-26.1%), with a mean absolute deviation of 5.71 (p = 0.01).
CONCLUSIONS: SAPC may decrease the risk of PCF in patients following TL. Based on the current data, SAPC appears to shorten the surgical time and the length of hospital stay. Nevertheless, prospective randomized trials are required to validate these findings.
Disciplines :
Otolaryngology
Author, co-author :
Chiesa-Estomba, Carlos M; Department of Otorhinolaryngology-Head and Neck Surgery, Hospital Universitario Donostia-Biodonostia Health Research Institute, Calle Doctor Begiristain, #1. CP. 20014, Donostia-San Sebastian, Gipuzkoa-Basque Country, Spain. chiesaestomba86@gmail.com ; Head and Neck Study Group of Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies (YO-IFOS), Marseille, France. chiesaestomba86@gmail.com
Mayo-Yanez, Miguel; Otorhinolaryngology-Head and Neck Surgery Department, Complexo Hospitalario Universitario A Coruña (CHUAC), 15006, A Coruña, Galicia, Spain ; Clinical Research in Medicine, International Center for Doctorate and Advanced Studies (CIEDUS), Santiago de Compostela, Spain ; Head and Neck Study Group of Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies (YO-IFOS), Marseille, France
Palacios-García, Jose M; Otorhinolaryngology-Head and Neck Surgery Department, Hospital Universitario Virgen Macarena, Seville, Spain ; Head and Neck Study Group of Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies (YO-IFOS), Marseille, France
Lechien, Jérome ; Université de Mons - UMONS > Faculté de Psychologie et des Sciences de l'Educatio > Service de Métrologie et Sciences du langage
Viljoen, Gerrit; Division of Otolaryngology, University of Cape Town, Groote Schuur Hospital, Cape Town, South Africa ; Head and Neck Study Group of Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies (YO-IFOS), Marseille, France
Karkos, Petros D; Department of Otolaryngology-Head and Neck Surgery, AHEPA University Hospital, Thessaloniki, Greece
Barillari, Maria R; Department of Mental and Physical Health and Preventive Medicine, "L. Vanvitelli" University, Naples, Italy ; Division of Otolaryngology-Head and Neck Surgery, Centre Hospitalier de L'Université de Montréal, Montreal, Canada
González-García, Jose A; Department of Otorhinolaryngology-Head and Neck Surgery, Hospital Universitario Donostia-Biodonostia Health Research Institute, Calle Doctor Begiristain, #1. CP. 20014, Donostia-San Sebastian, Gipuzkoa-Basque Country, Spain
Sistiaga-Suarez, Jon A; Department of Otorhinolaryngology-Head and Neck Surgery, Hospital Universitario Donostia-Biodonostia Health Research Institute, Calle Doctor Begiristain, #1. CP. 20014, Donostia-San Sebastian, Gipuzkoa-Basque Country, Spain
González-Botas, Jesus Herranz; Otorhinolaryngology-Head and Neck Surgery Department, Complexo Hospitalario Universitario A Coruña (CHUAC), 15006, A Coruña, Galicia, Spain ; Clinical Research in Medicine, International Center for Doctorate and Advanced Studies (CIEDUS), Santiago de Compostela, Spain
Ayad, Tareck; Division of Otolaryngology-Head and Neck Surgery, Centre Hospitalier de L'Université de Montréal, Montreal, Canada ; Head and Neck Study Group of Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies (YO-IFOS), Marseille, France
Ferlito, Alfio; Coordinator of the International Head and Neck Scientific Group, Padua, Italy
Language :
English
Title :
Stapler-Assisted Pharyngeal Closure After Total Laryngectomy: A Systematic Review and Meta-Analysis.
M112 - Anatomie humaine et Oncologie expérimentale
Research institute :
R550 - Institut des Sciences et Technologies de la Santé R350 - Institut de recherche en sciences et technologies du langage
Funding text :
No funding or sponsorship was received for this study or publication of this article. All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article, take responsibility for the integrity of the work as a whole, and have given their approval for this version to be published. Conceptualization, Carlos M Chiesa-Estomba, Miguel Mayo-Yanez and Jose M Palacios-García; methodology, Jerome Lechien; validation, Jose A González-García, and Jon A Sistiaga-Suarez; formal analysis, Miguel Mayo-Yanez; investigation, Carlos M Chiesa-Estomba, Miguel Mayo-Yanez and Gerrit Viljoen; data curation, Maria R Barillari; writing—original draft preparation, Carlos M Chiesa-Estomba and Gerrit Viljoen; writing—review and editing, Jesus Herranz González-Botas and Tareck Ayad; supervision, Alio Ferlito. Carlos M Chiesa-Estomba, Miguel Mayo-Yanez, Jose M Palacios-García, Jerome Lechien, Gerrit Viljoen, Petros D Karkos, Maria R Barillari, Jose A González-García, Jon A Sistiaga-Suarez, Jesus Herranz González-Botas, Tareck Ayad and Alio Ferlio confirm that they have no conflicts of interest to disclose. This systematic review is an initiative of the “Young Otolaryngologist Group of the International Federation of Otolaryngologic Societies” (YO-IFOS), and members and invitees of the International Head and Neck Scientific Group (IHNSG), were in compliance with ethics guidelines and followed the principles of the Helsinki Declaration of 1964 and its later amendments. Ethical approval by a committee was not required. All data generated or analyzed during this study are included in this published article, figures and tables.
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