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Primary versus secondary tracheoesophageal puncture: systematic review and meta-analysis

  • P D Chakravarty (a1), A E L McMurran (a2), A Banigo (a3), M Shakeel (a3) and K W Ah-See (a3)...
Abstract
Background:

Tracheoesophageal puncture represents the ‘gold standard’ 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.

Methods:

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.

Results:

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.

Conclusion:

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.

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Copyright
Corresponding author
Address for correspondence: Dr Patrick Daragh Chakravarty, Department of Otolaryngology, Head and Neck Surgery, Ward 11B, Queen Elizabeth University Hospital, Glasgow G51 4TF, Scotland, UK E-mail: p.d.chakravarty.08@aberdeen.ac.uk
References
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The Journal of Laryngology & Otology
  • ISSN: 0022-2151
  • EISSN: 1748-5460
  • URL: /core/journals/journal-of-laryngology-and-otology
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