Please use this identifier to cite or link to this item: https://observatorio.fm.usp.br/handle/OPI/55937
Title: Pharyngeal Reconstruction Methods to Reduce the Risk of Pharyngocutaneous Fistula After Primary Total Laryngectomy: A Scoping Review
Authors: SANABRIA, AlvaroOLIVERA, Maria PaulaCHIESA-ESTOMBA, CarlosHAMOIR, MarcKOWALSKI, Luiz P.LOPEZ, FernandoMAKITIE, AnttiROBBINS, K. ThomasRODRIGO, Juan PabloPIAZZA, CesareSHAHA, AshokSJOGREN, ElizabethSUAREZ, CarlosZAFEREO, MarkFERLITO, Alfio
Citation: ADVANCES IN THERAPY, v.40, n.9, p.3681-3696, 2023
Abstract: IntroductionThe 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.MethodsA 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.ResultsA 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.ConclusionWe 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.
Appears in Collections:

Artigos e Materiais de Revistas Científicas - FM/MCG
Departamento de Cirurgia - FM/MCG

Artigos e Materiais de Revistas Científicas - HC/ICHC
Instituto Central - HC/ICHC

Artigos e Materiais de Revistas Científicas - LIM/28
LIM/28 - Laboratório de Cirurgia Vascular e da Cabeça e Pescoço


Files in This Item:
File Description SizeFormat 
art_SANABRIA_Pharyngeal_Reconstruction_Methods_to_Reduce_the_Risk_of_2023.PDF
  Restricted Access
publishedVersion (English)1.18 MBAdobe PDFView/Open Request a copy

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.