{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T08:18:06Z","timestamp":1793521086773,"version":"4.5.0"},"reference-count":26,"publisher":"Cambridge University Press (CUP)","issue":"1","license":[{"start":{"date-parts":[[2017,11,27]],"date-time":"2017-11-27T00:00:00Z","timestamp":1511740800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Laryngol. Otol."],"published-print":{"date-parts":[[2018,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S0022215117002390_sec_a1\"><jats:title>Background:<\/jats:title><jats:p>Tracheoesophageal puncture represents the \u2018gold standard\u2019 for voice restoration following laryngectomy. Tracheoesophageal puncture can be undertaken primarily during laryngectomy or in a separate secondary procedure. There is no current consensus on which approach is superior. The current evidence comparing primary and secondary tracheoesophageal puncture was assessed.<\/jats:p><\/jats:sec><jats:sec id=\"S0022215117002390_sec_a2\" sec-type=\"methods\"><jats:title>Methods:<\/jats:title><jats:p>A systematic review and meta-analysis of articles comparing outcomes for primary and secondary tracheoesophageal puncture after laryngectomy were conducted. Outcome measures were: voice success, overall complication rate and pharyngocutaneous fistula rate.<\/jats:p><\/jats:sec><jats:sec id=\"S0022215117002390_sec_a3\" sec-type=\"results\"><jats:title>Results:<\/jats:title><jats:p>Eleven case series met the inclusion criteria, two prospective and nine retrospective. Meta-analysis did not demonstrate statistically significant differences in overall complication rate or voice outcomes, though it suggested a significantly increased risk of pharyngocutaneous fistula in primary compared to secondary tracheoesophageal puncture.<\/jats:p><\/jats:sec><jats:sec id=\"S0022215117002390_sec_a4\" sec-type=\"conclusion\"><jats:title>Conclusion:<\/jats:title><jats:p>Primary tracheoesophageal puncture is a safe and efficient approach for voice rehabilitation. However, secondary tracheoesophageal puncture should be preferred where there is a higher risk of pharyngocutaneous fistula.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s0022215117002390","type":"journal-article","created":{"date-parts":[[2017,11,27]],"date-time":"2017-11-27T10:27:27Z","timestamp":1511778447000},"page":"14-21","source":"Crossref","is-referenced-by-count":50,"title":["Primary versus secondary tracheoesophageal puncture: systematic review and meta-analysis"],"prefix":"10.1017","volume":"132","author":[{"given":"P D","family":"Chakravarty","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A E L","family":"McMurran","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Banigo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Shakeel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K W","family":"Ah-See","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2017,11,27]]},"reference":[{"key":"S0022215117002390_ref4","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2005.02.014"},{"key":"S0022215117002390_ref16","doi-asserted-by":"crossref","first-page":"412","DOI":"10.14639\/0392-100X-680","article-title":"Post-laryngectomy voice rehabilitation with voice prosthesis: 15 years experience of the ENT Clinic of University of Catania. 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