Inzidenz von Speichelfisteln in Abhängigkeit vom Zeitpunkt einer oralen Ernährung nach Laryngektomie

Abstract

Our results indicate that early oral feeding in the 1st postoperative week does not influence fistula formation after laryngectomy.

Perioperative Management of Total Laryngectomy Patients: A Survey of American Head and Neck Society Surgeons

“…There is high-quality evidence, including 3 randomized clinical trials and a recently published systematic review of the current literature demonstrating the safety of initiating early feeding in primary TL patients. 8,12,15,16 These studies found no difference in pharyngocutaneous fistula rates with early versus late feeding. Combining data from the available randomized clinical trials demonstrated that early feeding, defined as <5 days, was associated with a 6.7% fistula rate, while late feeding, defined as >7 days, was associated with a 10% fistula rate (P = .42).…”

“…For example, early oral feeding (typically defined as <5 days in the literature) following TL is not a widely accepted practice, but there is level I evidence as well as retrospective and prospective studies showing that it improves patient satisfaction, improves patient nutritional status, and decreases length of hospital stay without increasing pharyngocutaneous fistula rates compared with conventional oral feeding initiation (>7 days). [8][9][10][11][12][13][14][15][16] Perioperative antibiotic management is also not a uniform practice. In a retrospective review of 95 academic and affiliated hospitals across the United States, Langerman et al 17 found that there is substantial variability in antibiotic prophylaxis practices for TL with regard to duration of therapy and selection of antibiotic agents.…”

Delayed Oral Feeding in Patients of Salvage Laryngectomy and Its Effect on Development of Pharyngocutaneous Fistula

“…14 Traditionally the practice has been to have delayed oral feeds (up to 14 th post operative day). 15 However, recent studies have shown that there is no additional benefit to delaying oral feed in cases of primary total laryngectomy, and they recommend that EOF should be started routinely. 16 Incidence of PCF in our study was 20% which is comparable to that reported in the literature; ranging between 14-35%.…”

"Fístula faringocutânea após laringectomia total: revisão sistemática e implicações para a enfermagem"

“…O Ministério da Saúde (MS) estimou que, em 2002, o câncer no Brasil deveria chegar a 337.535 casos novos e 122.600 óbitos, dos quais 165.895 novos casos e 66.060 óbitos atingiriam a população masculina e 171.640 casos novos e 56.540 óbitos, a feminina. Estimou, ainda, que os principais tipos de câncer a acometer os homens seriam os de pele não-melanoma (36,57/100.000); próstata (29,76/100.00); pulmão (17,45/100.000) e estômago (16,14/100.000), ao passo que, as mulheres, teriam as neoplasias malignas da mama (40,66/100.000); pele nãomelanoma (34,56/100.00); colo de útero (19,82/100.000) e cólon e reto (11,04/100.000) (INSTITUTO NACIONAL DE CÂNCER, 2002).…”