The Comparative Analysis of Suture versus Linear Stapler Pharyngeal Closure in Total Laryngectomy: A Prospective Randomized Study

Özet

Objective: The aim of this study was to prospectivelyevaluate and compare the outcomes in patients undergoing pharyngeal closure with the linear stapler andsuture techniques after total laryngectomy.Methods: Forty-one patients who needed total laryngectomy for laryngeal cancer were enrolled in thestudy. Patients were randomized into two groups according to the pharyngeal closure technique: the linear stapler group (Group A) and the suture closuregroup (Group B). Rate of pharyngocutaneous fistula(PCF), nasogastric tube (NGT) removal time andpharyngeal closure time were analyzed and comparedbetween the two groups.Results: PCF developed in three patients in GroupA (14.3%) and in seven patients in Group B (35%).Although the rate of PCF was lower in Group A, thisdid not represent a statistical difference (p:0.129).Median NGT removal time was 12 days (IQR=3) and19.5 days (IQR=1) in Groups A and B, respectively.Median NGT removal time was not statistically different between the two groups (p:0.642). All patientswere able to swallow liquids and solids without difficulty. Median pharyngeal closure time was 3 minutes(IQR=1) and 37.5 minutes (IQR=9) in Groups A andB, respectively. Median pharyngeal closure time wassignificantly lower in Group A (p:0.00).Conclusion: The linear stapler technique in totallaryngectomy is a reliable, safe, easy-to-apply andtime-saving method. Closure with linear stapler significantly reduces pharyngeal closure time withoutadverse effect on NGT removal times and PCF rates.