Gastrostomy dependence following pharyngolaryngectomy: The effect of preoperative tube insertion

Head Neck. 2023 Oct;45(10):2649-2656. doi: 10.1002/hed.27490. Epub 2023 Aug 25.

Abstract

Background: The aim of this study is to investigate the impact of preoperative gastrostomy in patients undergoing pharyngolaryngectomy (PL) on gastrostomy tube dependence at 6 months postoperatively.

Methods: A retrospective review of patients undergoing PL for laryngeal squamous cell carcinoma between 2005 and 2019 was performed. Parameters were collected and analyzed within the multivariate models.

Results: Ninety-three patients (82% male, mean age 63.4 [SD 9.4]) were included. Preoperative tube placement and pharyngocutaneous fistula (PCF) were associated with an increased likelihood of gastrostomy tube dependence at 6 months (odds ratio 6.43, CI 1.1-38.3, p = 0.041) after adjusting for multiple confounding factors. There was no difference in the incidence of delayed oral feeding, PCF, or hospital stay between the groups.

Conclusions: Preoperative tube and PCF are associated with an increased likelihood of tube dependence at 6 months. Patients for preoperative tube insertion should be carefully selected and early oral feeding reintroduction should be encouraged.

Keywords: gastrostomy; laryngectomy; pharyngocutaneous fistula; pharyngolaryngectomy; swallowing function.

MeSH terms

  • Cutaneous Fistula* / surgery
  • Female
  • Gastrostomy / adverse effects
  • Humans
  • Laryngeal Neoplasms* / complications
  • Laryngeal Neoplasms* / surgery
  • Laryngectomy / adverse effects
  • Male
  • Middle Aged
  • Pharyngeal Diseases* / etiology
  • Postoperative Complications / etiology
  • Retrospective Studies