Our Summary

This study looked at the benefits of using a stapler in a type of surgery called “salvage total laryngectomy”, which is often used to treat throat cancer. The researchers compared two groups of patients: one group where the surgeon used a stapler (group A) and another where they stitched everything by hand (group B). The results showed that the group A had quicker operations, shorter hospital stays, and were able to start eating again sooner than group B. Additionally, fewer people in group A had cancer cells at the edge of the tissue removed during surgery, and they also had a lower rate of a complication called “pharyngocutaneous fistula”. However, this complication was more common in patients with diabetes and those who had undergone prior radiation treatment. The researchers concluded that using a stapler seemed to offer several benefits, but more studies are needed to confirm these findings.

FAQs

  1. What is salvage total laryngectomy and when is it used?
  2. What benefits did the use of a stapler show in the study compared to stitching by hand during salvage total laryngectomy?
  3. Are there any patient groups that showed a higher rate of complications in this study?

Doctor’s Tip

A helpful tip a doctor might tell a patient about laryngectomy is to discuss with their surgeon the possibility of using a stapler during the surgery. This technique can lead to quicker recovery, shorter hospital stays, and a lower risk of certain complications. However, it is important to consider individual factors such as diabetes or prior radiation treatment when making this decision. Ultimately, it is best to have a thorough discussion with your healthcare team to determine the best approach for your specific situation.

Suitable For

Patients who are recommended for laryngectomy are typically those with advanced stage laryngeal cancer that has not responded to other treatments such as radiation therapy or chemotherapy. Other indications for laryngectomy may include severe injury to the larynx, severe infections or other conditions that affect the function of the larynx. Each patient is evaluated on a case-by-case basis by their healthcare provider to determine if laryngectomy is the most appropriate treatment option for their specific condition.

Timeline

Before laryngectomy:

  1. Patient is diagnosed with throat cancer and discusses treatment options with their healthcare provider.
  2. Patient undergoes tests and evaluations to determine if laryngectomy is necessary.
  3. Patient may undergo chemotherapy or radiation therapy to shrink the tumor before surgery.
  4. Patient meets with a surgeon to discuss the procedure and potential risks and benefits.
  5. Patient undergoes laryngectomy surgery.

After laryngectomy:

  1. Patient wakes up in the hospital and may have a temporary tracheostomy tube to help with breathing.
  2. Patient may experience pain, swelling, and difficulty speaking or swallowing.
  3. Patient begins speech therapy to learn new ways of communication, such as using a electrolarynx or speech prosthesis.
  4. Patient may need to adjust their diet to softer foods and may receive nutrition through a feeding tube.
  5. Patient may experience emotional challenges and may benefit from counseling or support groups.
  6. Patient may need to undergo post-operative follow-up appointments and potentially additional treatments, such as radiation or chemotherapy.
  7. Patient gradually adjusts to life without a larynx and learns to manage any potential complications or side effects of the surgery.

What to Ask Your Doctor

  1. What is a laryngectomy and why is it recommended for me?
  2. What are the risks and potential complications associated with a laryngectomy?
  3. How will a laryngectomy affect my ability to speak and swallow?
  4. What is the recovery process like after a laryngectomy surgery?
  5. Are there any alternative treatments or surgical techniques available for my condition?
  6. How long will I need to stay in the hospital after the surgery?
  7. Will I need speech therapy or rehabilitation after the surgery?
  8. How often will I need follow-up appointments after the surgery?
  9. Are there any lifestyle changes or restrictions I need to be aware of after a laryngectomy?
  10. What is the success rate of a laryngectomy surgery, and what factors may affect my individual outcome?

Reference

Authors: Galli J, Salvati A, Di Cintio G, Mastrapasqua RF, Parrilla C, Paludetti G, Almadori G. Journal: Laryngoscope. 2021 Feb;131(2):E473-E478. doi: 10.1002/lary.28737. Epub 2020 May 16. PMID: 32415791