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Stapler Closure versus Manual Closure in Total Laryngectomy for Laryngeal cancer: A Systematic Review and Meta-Analysis
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  • Yi-Chan Lee,
  • Tuan-Jen Fang,
  • I-Chun Kuo,
  • Yao Te Tsai,
  • Li-Jen Hsin
Yi-Chan Lee
Chang Gung Memorial Hospital Keelung Branch
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Tuan-Jen Fang
Chang Gung Memorial Hospital Linkou Main Branch
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I-Chun Kuo
Chang Gung Memorial Hospital Linkou Branch
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Yao Te Tsai
Chang Gung Memorial Hospital Chiayi Branch
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Li-Jen Hsin
Chang Gung Memorial Hospital Linkou Main Branch
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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.

Peer review status:UNDER REVIEW

11 May 2020Submitted to Clinical Otolaryngology
14 May 2020Submission Checks Completed
14 May 2020Assigned to Editor
28 May 2020Reviewer(s) Assigned
19 Jul 2020Review(s) Completed, Editorial Evaluation Pending
21 Jul 2020Editorial Decision: Revise Minor
06 Aug 20201st Revision Received
07 Aug 2020Submission Checks Completed
07 Aug 2020Assigned to Editor
04 Sep 2020Reviewer(s) Assigned