Stapler Closure versus Manual Closure in Total Laryngectomy for
Laryngeal cancer: A Systematic Review and Meta-Analysis
Abstract
Abstract Objective: Total laryngectomy (TL) is a life-saving procedure
for individuals with advanced laryngeal cancer or those suffering from
recurrence after initial treatment. The present study aims to evaluate
the differences between stapler closure (SC) and manual closure (MC) of
the pharynx during TL for patients with laryngeal cancer.
Design/Setting: A systematic literature search was performed using the
PubMed, Embase and Cochrane Library. The data were analyzed using
Comprehensive Meta-Analysis software (Version 3; Biostat, Englewood,
NJ). Dichotomous data were calculated by odds ratio (OR) and continuous
data were calculated by mean difference (MD) with 95% confidence
intervals (CI). Main outcome/Results: A total of 7 studies (535
patients) were included in this meta‐analysis. Pooled analysis showed
that the operative time of TL was significantly reduced in the SC group
(MD, -63.2; 95% CI, -106.0 to -20.4). Moreover, the SC group had a
lower incidence of pharyngocutaneous fistula (OR = 0.38; 95% CI,
0.18-0.83; P = 0.016) and hospital stay (MD, -2.9; 95% CI, -5.6 to
-0.1). The incidence of postoperative surgical site infection
(OR = 0.41; 95% CI, 0.02-8.73; P = 0.565) was comparable between the
two groups. Conclusion: Based on these results, SC may be a useful
option for patients who need TL.