A Comparative Study on the Suture Method after Total Laryngectomy that Provide no Leakage under Highest Tension in Swine Small Intestine Suture Method after Laryngectomy that Provide no Leakage
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Abstract
ABSTRACT
Background: Pharyngocutaneous fistula is one of the most catastrophic complications after surgical treatment for neoplasm of larynx or lower pharynx. It may result in poor wound healing, prolonged
hospitalization, and delayed radiotherapy/chemotherapy, or eventually death. Suture technique in constructing a neopharynx is a main controllable factor in decreasing the incidence of pharyngocutaneous fistula.
Objectives: To compare four commonly used suture techniques after total laryngectomy (Connell, interrupted Lembert, continuous Lembert, and simple interrupted) that provides highest burst pressure.
Methodology: This is an experimental study. Cadaveric swine intestines were recruited (30 per group). Each suture technique was performed in each group. The time spent for sutures were recorded. The burst pressure was measured using air leak test. All data were presented as mean and standard deviation (SD) and analysed using One-way analysis (ANOVA), Multiple comparison test, and Fisher’s exact test. The P-value
Results: The statistically significantly (P < 0.05) highest burst pressure was achieved using the Connell technique (155.87 ± 44.45 mmHg) compared tointerrupted Lembert (122.90 ± 42.57 mmHg), and simple interrupted (79.97 ± 39.28 mmHg) In addition, the mean time spent for completing the sutures were also significantly shortest (P < 0.05) for the Connell technique (287.77 s)
Conclusion: The Connell technique provided the highest leak pressure and lowest time spent for constructing the neopharynx. However, our study did not study the effects of each suture technique on luminal stenosis, tensile strength and blood supply. Further study should be conducted in vivo.
Keywords: pharyngocutaneous fistula, burst pressure, suture technique, laryngectomy
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ต้นฉบับที่ส่งมาพิจารณายังวารสารหู คอ จมูก และใบหน้า จะต้องไม่อยู่ในการพิจารณาของวารสารอื่น ในขณะเดียวกันต้นฉบับที่จะส่งมาจะผ่านการอ่านโดยผู้ทรงคุณวุฒิ หากมีการวิจารณ์หรือแก้ไขจะส่งกลับไปให้ผู้เขียนตรวจสอบแก้ไขอีกครั้ง ต้นฉบับที่ผ่านการพิจารณาให้ลงตีพิมพ์ถือเป็นสมบัติของวารสารหู คอ จมูกและใบหน้า ไม่อาจนำไปลงตีพิมพ์ที่อื่นโดยไม่ได้รับอนุญาต
ตารางแผนภูมิ รูปภาพ หรือข้อความเกิน 100 คำที่คัดลอกมาจากบทความของผู้อื่น จะต้องมีใบยินยอมจากผู้เขียนหรือผู้ทรงลิขสิทธิ์นั้นๆ และใหร้ะบุกำกับไว้ในเนื้อเรื่องด้วย
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