Stapler-assisted total laryngectomy: surgical techniques and outcomes

Abstract Background The techniques used for the repair of the pharynx after total laryngectomy have an influence on the incidence of pharyngocutaneous fistula (PCF). Mechanical repair by staplers offers a reliable alternative as it achieves a water-tight tension-free closure. The current work aimed to highlight the surgical techniques and outcomes of stapler-assisted total laryngectomy. Methods We retrospectively collected data of 37 patients with advanced laryngeal carcinomas who underwent stapler-assisted total laryngectomy during 3 years. Vertical closure was done in 20 patients, while transverse closure was done in 17 patients. Results Pharyngocutaneous fistula was detected in 2/37 patients (5.4%). The mean time of pharyngeal repair was 1.9 min in the vertical technique and 1.7 min in the transverse technique, with no significant difference ( p = 0.754). Satisfactory swallowing outcomes were achieved in all patients. There was no significant difference between the vertical stapling technique and the horizontal technique regarding the swallowing outcomes. Conclusion The stapler represents a reliable method for pharyngeal closure following total laryngectomy. Stapler-assisted closure reduced the incidence of pharyngocutaneous fistula and shortened the operative time. In addition, it is associated with satisfactory swallowing outcomes. The transverse stapling technique is easy to perform, especially in patients with limited neck extension.