1 Introduction
The role of radiation-based therapy in laryngeal cancer has been well established by several prospective randomized trials1-3. However, total laryngectomy (TL) is still one of the treatment options for advanced cases or when the disease fails to respond to initial organ preservation therapy. One of the critical steps in TL is the closure of the pharyngeal mucosa after the removal of the entire larynx. Adequate pharyngotomy closure should be tension-free and watertight to prevent leakage. In addition, the viability of the pharyngeal mucosa needs to be maintained as much as possible. Manual suturing by hand, though time-consuming, is the technique traditionally used for pharyngeal closure after TL. Since the development of surgical staplers in 1908, these mechanical suturing devices have been increasingly used to connect tissue in a sterile and efficient way4. Surgical stapler closure of the pharyngeal defect after laryngectomy was first reported in 1971 by a Russian study5. Several authors subsequently reported their experiences comparing the differences between manual closure (MC) and stapler closure (SC) of the pharyngeal defect after TL. The purpose of the present study was to compare intraoperative and postoperative parameters between SC and MC in total laryngectomy for laryngeal cancer in the existing English literature.