Early oral feeding after total laryngectomy: A systematic review

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.

Keywords: carcinoma; cutaneous fistula; enteral nutrition; laryngeal neoplasms; laryngectomy; meta-analysis; postoperative complications; squamous cell.