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.