To compare perioperative and oncological outcomes between stapler and manual closure in patients undergoing total laryngectomy for advanced endolaryngeal squamous cell carcinoma.

Patients with advanced endolaryngeal tumours operated between July 2017 and July 2023 were retrospectively dichotomised into stapler closure and manual closure cohorts and compared.

Seventy-one patients with a median age of 57 years were included in our study. The median surgical duration was 270 minutes for the manual closure cohort and 245 minutes for the stapler closure cohort. The pharyngo-cutaneous salivary fistula rate was 6 per cent less in the stapler closure cohort. The estimated mean survival was not significantly different 54.5 months (95 per cent, confidence interval 46.3–62.71) in the manual closure cohort versus 28.12 months (95 per cent, confidence interval 23.6–32.63) in the stapler closure cohort (p = 0.79).

Stapler closure can be used in endolaryngeal tumours, and it reduces operating time, thus facilitating efficient utilisation of operation time with non-inferior oncological outcomes as compared to traditional manual closure.

To evaluate the utility of the hybrid tracheoesophageal puncture procedure in stapler-assisted laryngectomy.

Patients who underwent total laryngectomy at a single institution from 2009 to 2015 were reviewed. The interventions assessed were surgical creation of a tracheoesophageal puncture and placement of a voice prosthesis. The outcomes measured included voicing ability and valve failure.

Thirty-nine patients underwent total laryngectomy or pharyngolaryngectomy. Of these, nine underwent stapler-assisted laryngectomy; seven of the nine patients underwent concurrent stapler-assisted laryngectomy, cricopharyngeal myotomy and a hybrid tracheoesophageal puncture procedure. These seven patients were the focus of this review. Successful voicing and oral alimentation was achieved in all patients. Mean time to phonation was 30 days (range, 7–77 days) and mean time to first valve change was 90 days (range, 35–117 days).

Primary tracheoesophageal puncture with concurrent voice prosthesis placement and cricopharyngeal myotomy is easily performed with stapler-assisted laryngectomy. The hybrid tracheoesophageal puncture procedure is a simple method that enables a single operator to achieve primary tracheoesophageal puncture and valve placement; in addition, it facilitates concurrent cricopharyngeal myotomy.