title: Stapled closed technique for laryngectomy and pharyngeal repair.
abstract: OBJECTIVE
  Total laryngectomy is a recognised treatment for advanced laryngeal carcinoma. Traditionally, pharyngeal repair is performed with layered sutures. We describe our experience with a technique of closed pharyngoplasty using a linear stapler device.
  
  
  METHODS
  Ten total laryngectomies were performed from July 2002 to July 2004, using an Ethicon TLC 75 linear stapler for pharyngeal closure. Data collected included age, sex, staging, endoscopic assessment, surgical margins and post-operative course (including complications and swallowing).
  
  
  RESULTS
  Patients comprised eight men and two women. The mean age was 55.4 years. Six patients had stage T4 endolaryngeal carcinoma and four had stage T3. Four patients underwent pre-operative radiotherapy. Clear surgical margins were achieved in all patients. One patient developed a pharyngocutaneous fistula. Patients resumed oral intake at 48 hours, or at 72 hours if they had undergone pre-operative radiotherapy. Patients' mean hospital stay was seven days.
  
  
  CONCLUSIONS
  This stapled closed technique for pharyngoplasty is efficient and eliminates the risk of wound contamination, thus theoretically reducing the risk of tumour seeding. In addition, we were able to commence patients on oral fluids at a mean of 48 hours after surgery. The mean hospital stay was seven days. We recommend this technique as an alternative for repairing the pharynx in patients undergoing total laryngectomy for endolaryngeal carcinoma.
authors.affiliation: Department of Otolaryngology and Head and Neck Surgery, Grampian University Hospitals, Aberdeen Royal Infirmary, Scotland, UK. farhan099@hotmail.com
authors.forename: F
authors.initials: F
authors.lastname: Ahsan
authors.forename: K W
authors.initials: KW
authors.lastname: Ah-See
authors.forename: A
authors.initials: A
authors.lastname: Hussain
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D007822:Laryngeal Neoplasms / Q000601:surgery*; D007825:Laryngectomy / Q000379:methods* / Q000592:standards; D008297:Male; D008875:Middle Aged; D010610:Pharyngeal Neoplasms / Q000601:surgery*; D011182:Postoperative Care; D013528:Surgical Staplers / Q000592:standards*; D017792:Surgical Stapling / Q000379:methods* / Q000592:standards