{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T02:18:44Z","timestamp":1773109124142,"version":"3.50.1"},"reference-count":24,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2020,5,16]],"date-time":"2020-05-16T00:00:00Z","timestamp":1589587200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:sec><jats:title>Objectives\/Hypothesis<\/jats:title><jats:p>To analyze stapler benefits in salvage total laryngectomy in terms of surgical time, hospitalization length, oral feeding time, and occurrence of pharyngocutaneous fistula, and to evaluate risk factors for its onset.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospective analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>One hundred fourteen patients affected by endolaryngeal squamous cell carcinoma who underwent salvage total laryngectomy following primary treatment failure were reviewed. We divided patients into two groups based on type of pharyngeal suture performed: mechanical suture with stapler (group A) and manual suture (group B). These two groups were compared for surgical time, start of oral feeding, hospitalization length, surgical margins and pharyngocutaneous fistula incidence considering its relationship with diabetes mellitus, nutritional status, primary treatment, and neck dissection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In group A and group B, oral feeding restarting time was 15\u2009\u00b1\u20099.33 versus 20.03\u2009\u00b1\u200913.81\u2009days, hospitalization was 17.63\u2009\u00b1\u200910.08 versus 23.72\u2009\u00b1\u200914.29\u2009days, and surgery lasted 268.39\u2009\u00b1\u200976.93 versus 294.26\u2009\u00b1\u2009140.58\u2009minutes, respectively (<jats:italic>P<\/jats:italic>\u2009&lt;\u2009.05). Surgical margins resulted infiltrated in two patients (4.3%) in group A and 12 patients in group B (17.6%) (<jats:italic>P<\/jats:italic> = .03).<\/jats:p><jats:p>Twenty\u2010one patients (18.4%) presented with pharyngocutanoeus fistula. In group A and group B the incidence of fistula was 15.2% and 20.6%, respectively (<jats:italic>P<\/jats:italic> = .468). Fistula occurred in 7 of 18 diabetic patients (38.9%) and 14 of 96 (14.6%) nondiabetic patients (<jats:italic>P<\/jats:italic> = .015). Nineteen fistulas (90.5%) occurred in patients who had undergone previous radiation treatment (<jats:italic>P<\/jats:italic> = .013).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Using a stapler shortened operative time and hospitalization, while also providing a faster restart of oral feeding. Moreover, mechanical pharyngeal suture seems to decrease fistula rate even though its prevention role in salvage laryngectomy should be confirmed by further studies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4 <jats:italic>Laryngoscope<\/jats:italic>, 131:E473\u2013E478, 2021<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.28737","type":"journal-article","created":{"date-parts":[[2020,5,16]],"date-time":"2020-05-16T14:23:06Z","timestamp":1589638986000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Stapler Use in Salvage Total Laryngectomy: A Useful Tool?"],"prefix":"10.1002","volume":"131","author":[{"given":"Jacopo","family":"Galli","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology\u2013Head and Neck Surgery \u201cA. Gemelli\u201d Hospital Foundation Scientific Institute for Research, Hospitalization and Healthcare, Catholic University of the Sacred Heart  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio","family":"Salvati","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2013Head and Neck Surgery \u201cA. Gemelli\u201d Hospital Foundation Scientific Institute for Research, Hospitalization and Healthcare, Catholic University of the Sacred Heart  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6654-1585","authenticated-orcid":false,"given":"Giovanni","family":"Di Cintio","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2013Head and Neck Surgery \u201cA. Gemelli\u201d Hospital Foundation Scientific Institute for Research, Hospitalization and Healthcare, Catholic University of the Sacred Heart  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rodolfo F.","family":"Mastrapasqua","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2013Head and Neck Surgery \u201cA. Gemelli\u201d Hospital Foundation Scientific Institute for Research, Hospitalization and Healthcare, Catholic University of the Sacred Heart  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claudio","family":"Parrilla","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2013Head and Neck Surgery \u201cA. Gemelli\u201d Hospital Foundation Scientific Institute for Research, Hospitalization and Healthcare, Catholic University of the Sacred Heart  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gaetano","family":"Paludetti","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2013Head and Neck Surgery \u201cA. Gemelli\u201d Hospital Foundation Scientific Institute for Research, Hospitalization and Healthcare, Catholic University of the Sacred Heart  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giovanni","family":"Almadori","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2013Head and Neck Surgery \u201cA. Gemelli\u201d Hospital Foundation Scientific Institute for Research, Hospitalization and Healthcare, Catholic University of the Sacred Heart  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,5,16]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa031317"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0167-8140(02)00118-4"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0194-5998(98)70388-2"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2003.08.028"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/0003489414522972"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599810390914"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/MLG.0b013e3180332e39"},{"key":"e_1_2_7_9_1","first-page":"29","article-title":"Suturing of a laryngeal defectin laryngectomy","volume":"33","author":"Lukyianchenko AG","year":"1971","journal-title":"Vestn Otorhinolaringol"},{"key":"e_1_2_7_10_1","first-page":"465","article-title":"Mechanical sutures of the pharynx during total laryngectomy: proposal of a closed technique","volume":"10","author":"Simoncelli C","year":"1990","journal-title":"Acta Otorhinolaryngol Ital"},{"key":"e_1_2_7_11_1","first-page":"118","article-title":"Linear stapler closure of the pharynx during total laryngectomy: a 15\u2010year experience (from closed technique to semi\u2010closed technique)","volume":"27","author":"Altissimi G","year":"2007","journal-title":"Acta Otorhinolaryngol Ital"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-012-2111-7"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200008000-00035"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0001-6519(02)78319-2"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348941112000510"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0000000000003196"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.20280"},{"key":"e_1_2_7_18_1","first-page":"94","article-title":"Stapler suture of the pharynx after total laryngectomy","volume":"34","author":"Dedivitis RA","year":"2014","journal-title":"Acta Otorhinolaryngol Ital"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-009-0945-4"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.23326"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.23804"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.25786"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-018-5200-4"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.23337"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.129.1.44"}],"container-title":["The Laryngoscope"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Flary.28737","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.28737","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/lary.28737","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.28737","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,2]],"date-time":"2023-09-02T07:59:59Z","timestamp":1693641599000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lary.28737"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,5,16]]},"references-count":24,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2021,2]]}},"alternative-id":["10.1002\/lary.28737"],"URL":"https:\/\/doi.org\/10.1002\/lary.28737","archive":["Portico"],"relation":{},"ISSN":["0023-852X","1531-4995"],"issn-type":[{"value":"0023-852X","type":"print"},{"value":"1531-4995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,5,16]]},"assertion":[{"value":"2020-01-01","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-04-21","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-05-16","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}