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25‐year experience of using a linear stapler in laryngectomy
Author(s) -
Bedrin Lev,
Ginsburg Genadi,
Horowitz Zeev,
Talmi Yoav P.
Publication year - 2005
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.20280
Subject(s) - medicine , laryngectomy , surgery , swallowing , fistula , pharynx , tracheoesophageal fistula , larynx
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