title: Pharyngocutaneous fistula after total laryngectomy: Less common with mechanical stapler closure.
abstract: OBJECTIVE
  The aim of the study was to compare the incidences of pharyngocutaneous fistula after total laryngectomy between patients who underwent manual and mechanical suturing for pharyngoesophageal closure.
  
  
  METHODS
  In a retrospective and prospective nonrandomized clinical study conducted at a single tertiary medical center between May 2002 and April 2009, we compared the incidence of pharyngocutaneous salivary fistula between two groups of patients after total laryngectomy. Sixty-one consecutive patients who underwent mechanical suturing with a 60-mm linear stapler (group A) were prospectively enrolled, and 121 patients who had undergone manual suturing (group B) were retrospectively reviewed.
  
  
  RESULTS
  The groups were similar in terms of age, gender, comorbidities, TNM (tumor, node, metastasis) stage, and laryngeal tumor extension. The incidence of pharyngocutaneous salivary fistula was 4.9% in group A and 19.8% in group B (p = 0.014).
  
  
  CONCLUSIONS
  Mechanical stapler closure of the pharynx after total laryngectomy was associated with a significant reduction in the incidence of pharyngocutaneous fistula compared with manual suture in selected cases.
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Izmir Training and Research Hospital, Izmir, Turkey.
authors.forename: Caglar
authors.initials: C
authors.lastname: Calli
authors.forename: Ercan
authors.initials: E
authors.lastname: Pinar
authors.forename: Semih
authors.initials: S
authors.lastname: Oncel
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000601:surgery; D017577:Cutaneous Fistula / Q000209:etiology / Q000601:surgery*; D004867:Equipment Design; D005260:Female; D006801:Humans; D007822:Laryngeal Neoplasms / Q000601:surgery; D007825:Laryngectomy / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D013517:Otorhinolaryngologic Surgical Procedures / Q000295:instrumentation*; D010608:Pharyngeal Diseases / Q000209:etiology / Q000601:surgery*; D016156:Respiratory Tract Fistula / Q000209:etiology / Q000601:surgery*; D013528:Surgical Staplers; D013536:Suture Techniques / Q000295:instrumentation*; D016896:Treatment Outcome