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Does early oral feeding increase the likelihood of salivary fistula after total laryngectomy?

Published online by Cambridge University Press:  15 April 2014

A A Sousa ,
J M Porcaro-Salles ,
J M A Soares ,
G M de Moraes ,
G S Silva ,
R A Sepulcri  and
P R Savassi-Rocha
A A Sousa*
Affiliation:
Instituto Alfa de Gastroenterologia, Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
J M Porcaro-Salles
Affiliation:
Instituto Alfa de Gastroenterologia, Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
J M A Soares
Affiliation:
Department of Medicine, Universidade Federal de São João Del Rei, Divinópolis, Minas Gerais, Brazil
G M de Moraes
Affiliation:
Instituto Alfa de Gastroenterologia, Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
G S Silva
Affiliation:
Instituto Alfa de Gastroenterologia, Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
R A Sepulcri
Affiliation:
Department of Medicine, Universidade Federal de São João Del Rei, Divinópolis, Minas Gerais, Brazil
P R Savassi-Rocha
Affiliation:
Instituto Alfa de Gastroenterologia, Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
*
Address for correspondence: Dr. Alexandre Andrade Sousa, Avenida do Contorno 5351 sala 1206, Bairro Cruzeiro, CEP 30.310-035 Belo Horizonte, MG, Brazil Fax: (55)31-2535-1800 E-mail: alexandradeccp@gmail.com
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Abstract

Objective:

This study compared the incidence of salivary fistula between groups with an early or late reintroduction of oral feeding, and identified the predictive factors for salivary fistula.

Methods:

A randomised trial was performed using 89 patients with larynx or hypopharynx cancer, assigned to 2 groups (early or late). In the early group, oral feeding was started 24 hours after total laryngectomy or total pharyngolaryngectomy, and in the late group, it was started from post-operative day 7 onwards. The occurrence of salivary fistula was evaluated in relation to the following variables: early or late oral feeding, nutritional status, cancer stage, surgery performed, and type of neck dissection.

Results:

The incidence of salivary fistula was 27.3 per cent (n = 12) in the early group and 13.3 per cent (n = 6) in the late group (p = 0.10). The following variables were not statistically significant: nutritional status (p = 0.45); tumour location (p = 0.37); type of surgery (p = 0.91) and type of neck dissection (p = 0.62). A significant difference (p = 0.02) between the free margins and invasive carcinoma was observed.

Conclusion:

The early reintroduction of oral feeding in total laryngectomised patients did not increase the incidence of salivary fistula.

Keywords

LaryngectomyPharyngectomyPostoperative ComplicationsProtein-Calorie MalnutritionRisk FactorsEnteral Nutrition
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 128 , Issue 4 , April 2014 , pp. 372 - 378
Copyright
Copyright © JLO (1984) Limited 2014 

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