Eustaquio Marcia, Medina Jesus E, Krempl Greg A, Hales Nathan
Department of Otorhinolaryngology, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA.
Head Neck. 2009 Oct;31(10):1341-5. doi: 10.1002/hed.21098.
Our aim was to determine the feasibility and safety of initiating early oral feeding in patients who underwent salvage laryngectomy on postoperative day 5 and to review the rate of pharyngocutaneous fistula formation.
A retrospective review of 29 patients who underwent salvage laryngectomy was completed. Patients included in the study had radiation therapy +/- chemotherapy for laryngeal squamous cell carcinoma with subsequent total laryngectomy. Patients were excluded from analysis if they were reliant on a gastrostomy tube preoperatively, had a concurrent complete glossectomy, or developed a fistula before beginning oral feedings. Early oral feeding was initiated on postoperative day 5.
Twenty patients met complete inclusion criteria. Pharyngocutaneous fistula occurred in 10% (2/20) of the patients. Patients without postoperative complications on an average remained in the hospital for 7 days.
The risk of fistula formation is not increased and the duration of hospital stay may be shortened in patients who were given early postoperative feeds.
我们的目的是确定在接受挽救性喉切除术的患者术后第5天开始早期经口进食的可行性和安全性,并回顾咽瘘形成的发生率。
对29例接受挽救性喉切除术的患者进行了回顾性研究。纳入研究的患者因喉鳞状细胞癌接受了放疗+/-化疗,随后进行了全喉切除术。如果患者术前依赖胃造瘘管、同时进行了全舌切除术或在开始经口进食前出现瘘管,则排除在分析之外。术后第5天开始早期经口进食。
20例患者符合完全纳入标准。10%(2/20)的患者发生了咽瘘。术后无并发症的患者平均住院7天。
术后早期进食的患者瘘管形成风险未增加,住院时间可能缩短。