{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T08:08:31Z","timestamp":1767773311662,"version":"build-2238731810"},"reference-count":19,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,3,12]],"date-time":"2024-03-12T00:00:00Z","timestamp":1710201600000},"content-version":"vor","delay-in-days":11,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["International Wound Journal"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Pharyngocutaneous fistula (PCF) is a major complication after total laryngectomy, with significant morbidity and mortality. Whether mechanical stapler closure of the pharynx reduces fistula rates compared to hand\u2010sewn techniques remains unclear. We conducted an updated systematic review and meta\u2010analysis to clarify this question. Five databases were systematically searched from inception through November 2023 for studies comparing stapler versus suture closure for fistula outcomes after laryngectomy. Odds ratios (OR) were pooled using random\u2010effects models and fixed\u2010effects models. Subgroup and sensitivity analyses were performed. Risk of bias was appraised using NHLBI tools. Nine studies with 803 patients were included. Mechanical closure significantly reduced fistula incidence versus suture closure (OR\u2009=\u20090.57, 95% CI 0.34\u20130.95,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.03). Subgroup analysis found that stapling's protective effect varied by patient age, country\/region, linear stapler size and female percentage. Stapling reduced fistula odds by 80% in the Turkey subgroup (OR\u2009=\u20090.20, 95% CI 0.09\u20130.50) but showed no benefit in other regions. Patients &lt;60\u2009years showed an 84% fistula reduction with stapling (OR\u2009=\u20090.17, 95% CI 0.06\u20130.45), whereas older subgroups did not. Linear stapler size of 60\u2009mm significantly reduced fistula occurrence while 75\u2009mm did not. There was no evidence that low female percentage mitigated stapling benefits. Mechanical stapler closure after total laryngectomy meaningfully reduces the likelihood of postoperative PCF formation compared to hand\u2010sewn closure, especially for patients younger than 60\u2009years old. The absolute risk reduction supports its utility to prevent this complication.\n                  <\/jats:p>","DOI":"10.1111\/iwj.14751","type":"journal-article","created":{"date-parts":[[2024,3,12]],"date-time":"2024-03-12T23:50:35Z","timestamp":1710287435000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["RETRACTED: Impact of stapler versus manual closure techniques on pharyngocutaneous fistula development post\u2010total laryngectomy: A systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-4775-6086","authenticated-orcid":false,"given":"Shuo","family":"Ding","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology and Head and Neck Surgery, Beijing Tongren Hospital Capital Medical University  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yang","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology and Head and Neck Surgery, Beijing Tongren Hospital Capital Medical University  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wei","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology and Head and Neck Surgery, Beijing Tongren Hospital Capital Medical University  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gaofei","family":"Yin","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology and Head and Neck Surgery, Beijing Tongren Hospital Capital Medical University  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhigang","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology and Head and Neck Surgery, Beijing Tongren Hospital Capital Medical University  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qi","family":"Zhong","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology and Head and Neck Surgery, Beijing Tongren Hospital Capital Medical University  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,3,12]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.oraloncology.2008.05.017"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.24448"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.315.7109.629"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.anl.2015.04.002"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405\u2010009\u20100945\u20104"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348941112000510"},{"issue":"2","key":"e_1_2_8_8_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 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