Felipe Toyama Aires1, Rogério Aparecido Dedivitis2, Sílvia Miguéis Picado Petrarolha3, Wanderley Marques Bernardo4, Claudio Roberto Cernea5, Lenine Garcia Brandão5. 1. Department of Surgery, Hospital Ana Costa, Santos, Brazil. 2. Department of Head and Neck Surgery, Hospital das Clínicas, University of São Paulo School of Medicine, São Paulo, Brazil. 3. Department of Head and Neck Surgery, Hospital Ana Costa, Santos, Brazil. 4. Department of Evidence Based Medicine, Medical Sciences School of Santos - UNILUS, Santos, Brazil. 5. Department of Head and Neck Surgery, University of São Paulo School of Medicine, São Paulo, Brazil.
Abstract
BACKGROUND: Early oral feeding for patients who underwent total laryngectomy is still controversial. The purpose of this study was to evaluate the safety of initiating early oral feeding after total laryngectomy regarding pharyngocutaneous fistula. The survey included research in MEDLINE, EMBASE, and LILACS. METHODS: The intervention analyzed was early oral feeding (<5 days), whereas the control group received late oral feeding (>7 days) after total laryngectomy. RESULTS: From 304 studies, 4 randomized clinical trials with 180 patients were selected. In the early oral feeding group, the incidence was 6.7%, whereas in the late oral feeding group it was 10%, with no statistically significant difference (IC95% -0.11 to 0.05; p = .42; I(2) = 0%). Four cohort studies with 490 patients were also selected. In the early oral feeding group, the incidence was 12.2%, whereas in the other group, it was 10.1%, with no statistically significant difference (IC95% -0.05 to 0.08; p = .67; I2 = 0%). CONCLUSION: There is no increase in pharyngocutaneous fistula rates in patients who receive early oral feeding after total laryngectomy.
BACKGROUND: Early oral feeding for patients who underwent total laryngectomy is still controversial. The purpose of this study was to evaluate the safety of initiating early oral feeding after total laryngectomy regarding pharyngocutaneous fistula. The survey included research in MEDLINE, EMBASE, and LILACS. METHODS: The intervention analyzed was early oral feeding (<5 days), whereas the control group received late oral feeding (>7 days) after total laryngectomy. RESULTS: From 304 studies, 4 randomized clinical trials with 180 patients were selected. In the early oral feeding group, the incidence was 6.7%, whereas in the late oral feeding group it was 10%, with no statistically significant difference (IC95% -0.11 to 0.05; p = .42; I(2) = 0%). Four cohort studies with 490 patients were also selected. In the early oral feeding group, the incidence was 12.2%, whereas in the other group, it was 10.1%, with no statistically significant difference (IC95% -0.05 to 0.08; p = .67; I2 = 0%). CONCLUSION: There is no increase in pharyngocutaneous fistula rates in patients who receive early oral feeding after total laryngectomy.
Authors: Liset Lansaat; Vincent van der Noort; Simone E Bernard; Simone E J Eerenstein; Boudewijn E C Plaat; Ton A P M Langeveld; Martin Lacko; Frans J M Hilgers; Remco de Bree; Robert P Takes; Michiel W M van den Brekel Journal: Eur Arch Otorhinolaryngol Date: 2018-01-16 Impact factor: 2.503