Modified Continuous Mucosal Connell Suture for the Pharyngeal Closure After Total Laryngectomy: Zipper Suture.
OBJECTIVE
Pharyngocutaneous fistula is a serious complication after total laryngectomy, and there are some risk factors stated in the literature. The surgical suture techniques are not studied so much. The aim of this study is to evaluate the effectiveness of 'modified continuous mucosal Connell suture' on the incidence of pharyngocutaneous fistula after total laryngectomy.


METHODS
This is a retrospective case series study based at a tertiary center with 31 patients who underwent total laryngectomy between July 2011 and December 2013. Pharyngocutaneous fistula formation after total laryngectomy was evaluated with the patients who underwent modified continuous mucosal Connell suture for pharyngeal repair.


RESULTS
Pharyngocutaneous fistula was observed in only one patient (3.2%) who had a history of previous radiotherapy, and it was spontaneously healed within 6 days by conservative treatment.


CONCLUSIONS
We defined a new suture technique for the pharyngeal repair after total laryngectomy. This technique is a simple modification of continuous mucosal Connell suture. We named it as zipper suture. It is effective in the prevention of pharyngocutaneous fistula for pharyngeal reconstruction after total laryngectomy.
Department of Otorhinolaryngology, Bursa Sevket Yilmaz Training and Research Hospital, Bursa, Turkey.
Mehmet
M
Haksever
Department of Otorhinolaryngology, Bursa Sevket Yilmaz Training and Research Hospital, Bursa, Turkey.
Davut
D
Akduman
Department of Otorhinolaryngology, Bursa Sevket Yilmaz Training and Research Hospital, Bursa, Turkey.
Sundus
S
Aslan
Department of Otorhinolaryngology, Bursa Sevket Yilmaz Training and Research Hospital, Bursa, Turkey.
Fevzi
F
Solmaz
Department of Otorhinolaryngology, Bursa Sevket Yilmaz Training and Research Hospital, Bursa, Turkey.
Suay
S
Ozmen
Fistula; Laryngectomy; Suture Techniques, Risk Factors, Drainage; Zipper Suture