Abstract
Introduction The main modalities of surgical treatment for laryngeal cancer include transoral
laser microsurgery (TLM), open preservation surgery, and total laryngectomy (TL).
In the elderly, for the presence of comorbidities, the surgical approach more appropriate
in many cases remains TL. The use of a stapler for the closure of the esophagus has
been introduced to reduce surgical time and postoperative complications such as pharyngocutaneous
fistula (PCF).
Objective In the present study, we have evaluated the effectiveness of the use of the horizontal
mechanical pharyngoesophageal closure in patients who underwent TL.
Methods This nonrandomized study was performed on consecutive patients with histopathologically
proven squamous cell endolaryngeal carcinoma. The TL was performed using a linear
stapler to mechanically suture the pharyngotomy using the semiclosed technique.
Results A total of 33 patients underwent TL, and 13 of them underwent neck dissection. A
total of 15 patients (45.4%) were ≤70 years old, and 18 were > 70 years old. Analyzing
the results in relation to age, patients > 70 years old showed tumors at an earlier
stage than those aged ≤70 years old. Furthermore, in this group there was a greater
number of patients who had comorbidities (p = 0.014). In total, we had 2 (6%) cases of PCF in 6.6% in the group ≤70 years old,
and in 5.5% of the group > 70 years old (p = 1.00).
Conclusions The use of the stapler for the horizontal closure of the pharyngoesophagectomy in
the patients subjected to TL is proven to be useful and safe even when used in elderly
patients.
Keywords
total laryngectomy - laryngeal cancer - pharyngocutaneous fistula
