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Efficacy of stapler pharyngeal closure after total laryngectomy: A systematic review
Author(s) -
Aires Felipe T.,
Dedivitis Rogério A.,
Castro Mario Augusto F.,
Bernardo Wanderley Marques,
Cernea Claudio Roberto,
Brandão Lenine Garcia
Publication year - 2014
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.23326
Subject(s) - medicine , laryngectomy , pharynx , surgery , confidence interval , fibrous joint , incidence (geometry) , larynx , optics , physics
Background Some primary studies compare manual and mechanical pharyngeal closures after total laryngectomy. The purpose of this study was to evaluate the advantages of the mechanical suture in pharyngeal closure. Methods The literature survey included research in MEDLINE, EMBASE, and LILACS. The intervention analyzed was stapler‐assisted pharyngeal closure, whereas the control group was manual suture pharyngeal closure. Results The survey resulted in 319 studies. However, 4 studies were selected (417 patients). In the group of patients in whom the stapler was used, the incidence of pharyngocutaneous fistula was 8.7%, whereas in the other, it was 22.9%, with an absolute risk reduction of 15% (95% confidence interval [CI], 0.02–0.28; p = .02; I 2 = 66%). Regarding the surgical time, the average difference was 80 minutes in favor of the stapler group (95% CI, 23.16–136.58 minutes; p < .006). Conclusion The difference for starting oral feeding was 8 days in favor of the mechanical suture (95% CI, 4.01–11.73 days; p < .001). Patients who underwent mechanical suture had a shorter hospitalization period. © 2013 Wiley Periodicals, Inc. Head Neck 36 : 739–742, 2014