Our Summary

This research examines whether using a mechanical stapler to close up the throat after a laryngectomy (a surgery to remove the voice box) is better at preventing a common complication, a fistula (an abnormal hole), than manually sewing the wound closed.

Nine studies involving 803 patients were examined. The results showed that using a mechanical stapler significantly reduced the chance of a fistula forming compared to sewing by hand. This was especially true for patients under 60 years old.

The study found that stapling was particularly effective in Turkey but not in other regions. Also, the size of the stapler mattered - a 60mm stapler significantly reduced fistula occurrence while a 75mm one did not. The study found no evidence that the benefits of stapling were less for women.

In simple terms, this research suggests that using a mechanical stapler to close up the throat after removing the voice box can help prevent a common complication, particularly in patients under 60.

FAQs

  1. What was the main finding of the research about using a mechanical stapler in laryngectomy?
  2. Was the use of a mechanical stapler to close the wound after a laryngectomy equally effective in all regions and for all patients?
  3. Does the size of the mechanical stapler used in laryngectomy affect the chances of a fistula forming?

Doctor’s Tip

A helpful tip a doctor might tell a patient about laryngectomy is to consider using a mechanical stapler to close up the throat after surgery, as it can significantly reduce the chance of developing a fistula compared to manually sewing the wound closed. This method may be especially beneficial for younger patients and those in certain regions, so it’s important to discuss this option with your healthcare provider.

Suitable For

Patients who are recommended for a laryngectomy typically include those with:

  1. Advanced laryngeal cancer that cannot be treated with other methods such as radiation or chemotherapy.
  2. Recurrent laryngeal cancer that has come back after previous treatment.
  3. Severe damage to the larynx due to trauma or radiation therapy.
  4. Severe chronic respiratory issues that require the removal of the voice box to improve breathing.
  5. Patients who have failed other treatments for laryngeal cancer or other conditions affecting the larynx.

It is important for patients to discuss the potential risks and benefits of a laryngectomy with their healthcare provider to determine if it is the most appropriate treatment option for their specific condition.

Timeline

Before a laryngectomy, a patient may experience symptoms such as difficulty breathing, swallowing, or speaking, as well as pain or discomfort in the throat. They may undergo various tests and consultations with healthcare providers to determine if a laryngectomy is necessary.

After a laryngectomy, the patient will no longer have a voice box and will need to learn how to communicate using alternative methods such as writing, sign language, or speech therapy. They may also undergo rehabilitation to learn how to swallow and breathe properly without a voice box.

In terms of the surgical procedure itself, the use of a mechanical stapler to close the wound in the throat after a laryngectomy has been shown to be more effective at preventing fistulas compared to manual sewing. This can help reduce complications and improve outcomes for patients, particularly those under 60 years old.

What to Ask Your Doctor

  1. What are the potential complications of a laryngectomy surgery?
  2. How will my quality of life be affected after a laryngectomy?
  3. What is the difference between using a mechanical stapler and manually sewing the wound closed after a laryngectomy?
  4. What are the potential benefits of using a mechanical stapler for closure after a laryngectomy?
  5. Are there any specific factors, such as age or region, that may affect the effectiveness of using a mechanical stapler?
  6. What type and size of mechanical stapler would be used for my procedure?
  7. What is the success rate of using a mechanical stapler compared to manual closure in preventing fistula formation?
  8. Are there any potential risks or side effects associated with using a mechanical stapler for closure after a laryngectomy?
  9. How long is the recovery period after using a mechanical stapler for closure compared to manual closure?
  10. Are there any alternative methods of closure that should be considered for my specific case?

Reference

Authors: Ding S, Zhang Y, Guo W, Yin G, Huang Z, Zhong Q. Journal: Int Wound J. 2024 Mar;21(3):e14751. doi: 10.1111/iwj.14751. PMID: 38472132