25-year experience of using a linear stapler in laryngectomy

Background. Stapler application for pharyngeal closure after total laryngectomy allows for rapid watertight closure without field contamination and for potentially reduced fistula rate. Methods. One thousand four hundred fifteen patients underwent laryngectomy with linear stapler closure. In 98.6%,...

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Published inHead & neck Vol. 27; no. 12; pp. 1073 - 1079
Main Authors Bedrin, Lev, Ginsburg, Genadi, Horowitz, Zeev, Talmi, Yoav P.
Format Journal Article
LanguageEnglish
Published Hoboken Wiley Subscription Services, Inc., A Wiley Company 01.12.2005
Subjects
Adult
Aged
Aged, 80 and over
Deglutition Disorders - etiology
Equipment Design
Female
fistula
Fistula - etiology
Humans
laryngectomy
Laryngectomy - instrumentation
Laryngectomy - methods
larynx
Male
mechanical suturing
Middle Aged
Neoplasm Recurrence, Local
Pharyngeal Diseases - etiology
Speech Intelligibility
stapler
stapling device
Surgical Staplers - adverse effects
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Summary:Background. Stapler application for pharyngeal closure after total laryngectomy allows for rapid watertight closure without field contamination and for potentially reduced fistula rate. Methods. One thousand four hundred fifteen patients underwent laryngectomy with linear stapler closure. In 98.6%, laryngectomy was performed after radiation failure. Results. A relatively high incidence of pharyngeal fistulae (12%) was seen, although these rates were reduced to 5.5% during the recent decade. Simultaneous creation of tracheoesophageal fistula and myotomy by a novel technique was introduced. Swallowing problems were observed in 11 patients and local recurrences in nine patients (0.6%). Conclusion. The advantages of mechanical sutures with the closed stapling technique are simple and rapid application, watertight closure with good hemostasis, prevention of field contamination, good speech and deglutition, no increase in fistula rate, and low local recurrence rates. Operating room expenses may also be significantly reduced, rendering this method cost‐effective as well. © 2005 Wiley Periodicals, Inc. Head Neck 27: XXX–XXX, 2005
Bibliography:istex:2F0D9A3A61BB7AE744B0039523DF799E8706A99F
ArticleID:HED20280
Presented in part in the 6th International Conference on Head and Neck Cancer, Washington, DC, August 7-11, 2004
ark:/67375/WNG-Z6X5B8WT-D
Presented in part in the 6th International Conference on Head and Neck Cancer, Washington, DC, August 7–11, 2004
Dr. Bedrin, MD, PhD, trained in the Department of Head and Neck Surgery at the Regional Oncological Center in Ekaterinburg in the Russian Federation as an attending surgeon for 15 years. From 1992 he is an attending physician at the Department of Otolaryngology, Head and Neck Surgery at the Chaim Sheba Medical Center, Tel Hashomer Israel.
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ISSN:1043-3074
1097-0347
DOI:10.1002/hed.20280