Pharyngeal Reconstruction Methods to Reduce the Risk of Pharyngocutaneous Fistula After Primary Total Laryngectomy: A Scoping Review.
Laryngectomy
Meta-analysis
Reconstruction
Suture
Systematic review
Journal
Advances in therapy
ISSN: 1865-8652
Titre abrégé: Adv Ther
Pays: United States
ID NLM: 8611864
Informations de publication
Date de publication:
09 2023
09 2023
Historique:
received:
21
02
2023
accepted:
17
05
2023
medline:
16
8
2023
pubmed:
12
7
2023
entrez:
12
7
2023
Statut:
ppublish
Résumé
The most common early postoperative complication after total laryngectomy (TL) is pharyngocutaneous fistula (PCF). Rates of PCF are higher in patients who undergo salvage TL compared with primary TL. Published meta-analyses include heterogeneous studies making the conclusions difficult to interpret. The objectives of this scoping review were to explore the reconstructive techniques potentially available for primary TL and to clarify which could be the best technique for each clinical scenario. A list of available reconstructive techniques for primary TL was built and the potential comparisons between techniques were identified. A PubMed literature search was performed from inception to August 2022. Only case-control, comparative cohort, or randomized controlled trial (RCT) studies were included. A meta-analysis of seven original studies showed a PCF risk difference (RD) of 14% (95% CI 8-20%) favoring stapler closure over manual suture. In a meta-analysis of 12 studies, we could not find statistically significant differences in PCF risk between primary vertical suture and T-shaped suture. Evidence for other pharyngeal closure alternatives is scarce. We could not identify differences in the rate of PCF between continuous and T-shape suture configuration. Stapler closure seems to be followed by a lower rate of PCF than manual suture in those patients that are good candidates for this technique.
Identifiants
pubmed: 37436593
doi: 10.1007/s12325-023-02561-7
pii: 10.1007/s12325-023-02561-7
pmc: PMC10427525
doi:
Types de publication
Journal Article
Review
Langues
eng
Pagination
3681-3696Commentaires et corrections
Type : ErratumIn
Informations de copyright
© 2023. The Author(s).
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