Early oral feeding following total laryngectomy

Abstract

Background: Pharyngocutaneous fistula is a serious complication after total laryngectomy. The reported incidence varies from 1% to 50%. There is still no agreement regarding when to begin oral feeding after total laryngectomy. The aim of this study was to demonstrate the safety of early oral feeding after total laryngectomy. Materials and Methods: In a prospective study, patients who underwent total laryngectomy were randomly divided into either the oral feeding or the nasogastric tube (NGT) groups. For patients in the oral feeding group, feeding was initiated orally with a clear liquid diet on the third postoperative day, whereas patients in the nasogastric tube group were fed through NGT and received nothing orally until the seventh postoperative day. Results: Between September 2002 and October 2006, 25 patients were studied in this trial. There were 13 patients (52%) in the oral feeding group and 12 patients (48%) in the NGT group. Their ages ranged from 49 to 77 years (mean 66.07 ±7.22 and 63.83 ± 7.58 years in oral feeding and NGT groups, respectively). Mann-Whitney U and Chi-square tests showed that differences between the two groups were not statistically significant with regard to age, tumor location and tumor stage. One case of fistula occurred in each group. Conclusion: Our results indicate that in a selected group of patients, it is possible to initiate oral feeding much earlier in the postoperative period than what was formerly thought. ©2008 NRITLD, National Research Institute of Tuberculosis and Lung Disease, Iran.