title: Evaluation of stapled closure following laryngectomy for carcinoma larynx in an Indian tertiary cancer centre.
abstract: OBJECTIVE
  Stapling devices are used for pharyngeal closure after laryngectomy for the past few decades although it has not gained wide acceptance. This study is aimed at evaluating the role of stapler in pharyngeal closure after laryngectomy.
  
  
  METHODS
  Thirty consecutive patients who underwent stapled laryngectomy at our institution from October 2004 to February 2008 were evaluated retrospectively. Linear stapler (Proximate TX 60; Ethicon Inc.) was used for closure of neopharynx.
  
  
  RESULTS
  There were 28 males and 2 females with mean age of 54.5 years (54.5 ± 11.2). Nineteen of these patients (63.3%) had salvage laryngectomy and two patients (6.7%) had laryngectomy for a second primary tumor. Twenty-eight patients had total laryngectomy (TL), whereas two had extended TL. Eight patients had salivary leak (26.7%). Of these, 6 (75%) had prior radiation. All salivary leaks except one were managed conservatively. Follow-up ranged from 7 to 54 months (median: 21 months). Seven patients (23.3%) developed recurrence, six at the stoma, of which 5 (83.3%) had initial extension of disease to the subglottis. Four-year disease-free survival was 54.4%.
  
  
  CONCLUSIONS
  Pharyngeal closure by linear stapler is an efficient and safe method of fashioning the neopharynx after laryngectomy with no added risk of occurrence of pharyngocutaneous fistula in primary and salvage laryngectomies.
authors.forename: S
authors.initials: S
authors.lastname: Babu
authors.affiliation: Department of Surgical Oncology, Regional Cancer Centre, Trivandrum, India.
authors.forename: B T
authors.initials: BT
authors.lastname: Varghese
authors.forename: E M
authors.initials: EM
authors.lastname: Iype
authors.forename: P S
authors.initials: PS
authors.lastname: George
authors.forename: P
authors.initials: P
authors.lastname: Sebastian
mesh_terms: D000328:Adult; D000368:Aged; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007194:India; D007822:Laryngeal Neoplasms; D007825:Laryngectomy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D062606:Tertiary Care Centers