Galazka Adam, Stawarz Katarzyna, Bienkowska-Pluta Karolina, Paszkowska Monika, Misiak-Galazka Magdalena
Department of Head and Neck Cancer, Maria Skłodowska-Curie National Research Institute of Oncology, Warsaw 02-781, Mazowieckie, Poland.
Department of Dermatology, Maria Sklodowska-Curie Medical Academy, Evimed Medical Center Ltd., Warsaw 00-136, Mazowieckie, Poland.
World J Clin Oncol. 2025 Jul 24;16(7):109246. doi: 10.5306/wjco.v16.i7.109246.
The rising incidence of laryngeal cancer has led to an increasing number of total laryngectomy procedures. While voice prostheses have significantly improved post-laryngectomy rehabilitation, the risk of salivary fistula remains a major complication. This study aims to compare the stapler and hand-sewn techniques for esophageal closure and evaluate their impact on fistula formation.
To compare stapler-assisted and hand-sewn esophageal closure techniques after laryngectomy regarding their impact on salivary fistula formation.
A total of 52 patients (44 men, 8 women), aged 43 to 77 years, underwent total laryngectomy. Esophageal reconstruction was performed using either a stapler (29 patients) or a hand-sewn technique (23 patients). A surgical stapler TA was used for esophageal closure in the stapler group. Patients were clinically monitored for fistula formation during the first 7 days postoperatively and again two weeks after discharge using fiberoptic examination.
A total of 22 salivary fistulas were recorded: 17 (77.3%) occurred following the hand-sewn technique, while 5 (22.7%) developed in the stapler group. Additionally, preoperative radiotherapy was identified as a statistically significant risk factor for fistula formation. No technical complications related to the stapler device were observed.
Although hand-sewn closure is commonly used after total laryngectomy, stapler-assisted closure shows lower fistula rates and is a viable esophageal reconstruction alternative.
喉癌发病率的上升导致全喉切除术的数量不断增加。虽然语音假体显著改善了喉切除术后的康复，但唾液瘘的风险仍然是一个主要并发症。本研究旨在比较吻合器和手工缝合技术用于食管闭合的效果，并评估它们对瘘管形成的影响。
比较喉切除术后吻合器辅助和手工缝合食管闭合技术对唾液瘘形成的影响。
共有52例患者（44例男性，8例女性），年龄在43至77岁之间，接受了全喉切除术。食管重建采用吻合器（29例患者）或手工缝合技术（23例患者）。吻合器组使用手术吻合器TA进行食管闭合。术后第1周对患者进行临床监测，观察瘘管形成情况，并在出院后两周再次使用纤维光学检查。
共记录到22例唾液瘘：手工缝合技术组发生17例（77.3%），吻合器组发生5例（22.7%）。此外，术前放疗被确定为瘘管形成的统计学显著风险因素。未观察到与吻合器装置相关的技术并发症。
虽然全喉切除术后通常采用手工缝合闭合，但吻合器辅助闭合显示出较低的瘘管发生率，是一种可行的食管重建替代方法。
