Linear stapler closure of the pharynx in laryngectomy: our experience (endoscopic closed technique)

Background: Total laryngectomy is the surgical treatment for advanced laryngeal carcinoma. Recently it’s used the linear stapler to treat laryngeal carcinoma. The pharyngeal repair is performed with layered sutures, or using a linear stapler device, using technique of closed pharyngoplasty with linear stapler, by laryngoscope’s guide to see and to hook epiglottis through the trachea. Methods: We compared the results between total laryngectomy technique with conventional manual suture with needle and gut and closed technique adopted by our otolaryngology’s service with mechanical stapler (GIA) in advanced laryngeal carcinoma. We used a linear stapler Ethicon endo-surgery 90 mm (Proximate) with 76 titanium staples and an integrated scalpel (dimension open suture: 3.0 mm × 3.85 mm) and an endoscope (2.7 mm 0°). Results: We had an important reduction of surgical times, less immediate complications, reduction of length of stay in hospital with the gastric nose tube and reduction of general length of hospital stay. Conclusions: Comparing to the traditional technique, the use of mechanical sutures improve significantly: the surgical time, reducing the length of hospital stay, restoring the physiological oral nutrition and the time of removal of the gastric nose tube. Finally, we demonstrated the reduction in the incidence of complications such as fistula and postoperative fever