Calli Caglar, Pinar Ercan, Oncel Semih
Department of Otorhinolaryngology-Head and Neck Surgery, Izmir Training and Research Hospital, Izmir, Turkey.
Ann Otol Rhinol Laryngol. 2011 May;120(5):339-44. doi: 10.1177/000348941112000510.
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.
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.
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).
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.
本研究旨在比较全喉切除术后采用手工缝合和机械缝合进行咽食管闭合的患者咽皮肤瘘的发生率。
在2002年5月至2009年4月于一家三级医疗中心进行的一项回顾性和前瞻性非随机临床研究中，我们比较了两组全喉切除术后患者咽皮肤唾液瘘的发生率。前瞻性纳入61例连续使用60毫米线性吻合器进行机械缝合的患者（A组），并回顾性分析121例接受手工缝合的患者（B组）。
两组在年龄、性别、合并症、TNM（肿瘤、淋巴结、转移）分期和喉肿瘤扩展方面相似。A组咽皮肤唾液瘘的发生率为4.9%，B组为19.8%（p = 0.014）。
在特定病例中，全喉切除术后采用机械吻合器闭合咽部与手工缝合相比，咽皮肤瘘的发生率显著降低。
