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Study details | Number of patients | Early feeding (intervention) | Late feeding (control) | Inclusion | Exclusion |
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Seven et al. [27] 2003 Turkey RCT | 65 | Liquid diet 24 hours following surgery and oral diet as tolerated (32 patients) | Fed through TEP tube and started oral feeds on the 7th postoperative day (33 patients) | Total laryngectomy surgery with primary closure for malignant cancers of larynx who were also candidates for primary TEP November 1999 to March 2002 | Requirement for tissue flap TEP not performed |
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Sharifian et al. [28] 2008 Iran RCT | 25 | Sips of water started on the 3rd postoperative day and built up (13 patients) | Oral feeds started on the 7th day if fistula is not present (12 patients) | Total laryngectomy for malignant tumours of larynx, September 2002–October 2006 | Previous surgery for tumour Surgery for aspiration Invasive thyroid cancers Postcricoid/oesophagus cancers Preoperative radiotherapy and partial laryngectomy surgeries |
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Song et al. [29] 2003 China RCT | 42 | Oral feeding 48–72 hours after surgery (21 patients) | Oral feeding 10–12 days after surgery (21 patients) | Total laryngectomy for larynx and pyriform fossa tumours of squamous cell carcinomas July 2000–July 2002 | Not clear |
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Volling et al. [30] 2001 Germany RCT | 42 | Staggered feeding regime. All patients orally fed before the 7th day were included (31 patients) | Staggered feeding regime with all patients fed on the 7th day or afterwards included (11 patients) | Total laryngectomy for advanced or recurrent cancer February 1, 1996, to June 30, 1996 | Distant metastasis Need for tissue flap |
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Aswani et al. [31] 2009 South Africa CCT | 79 | Clear oral fluids from postoperative day 2, to be built up to free fluids on the 3rd day, soft diet on the 4th day, and normal diet on the 5th day (40 patients) | Tube fed (either nasogastric or TEP) until the 7th day when oral feeding was started (39 patients) | Total laryngectomy November 2002 to December 2006 | Myocutaneous flaps Tumour extension into tongue base Operative complication (cricopharyngeal myotomy breaching mucosa) |
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Medina and Khafif [32] 2001 USA CCT | 73 | Oral feeding at 48 hours (group one 20 patients and group two 35 patients) | Feeding started on 7 to 10 days following surgery (18 patients) | Total laryngectomy for cancer of larynx Normal preoperative blood tests | Neck irradiation (any preoperative irradiation apart from that for T1/2 laryngeal cancers with narrow field irradiation) Previous cancer operation in aerodigestive tract Patients with synchronous tumours |
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Prasad et al. [14] 2006 India CCT | 78 | Oral feeds started on the 2nd postoperative day (40 patients) | Oral feeds at the 10th postoperative day (38 patients) | Treated by the same surgeon of laryngeal surgery for malignant tumour Normal preoperative bloods Primary reconstruction Good family support; 8 patients of study group had subtotal laryngectomies | Postcricoid tumours Myocutaneous flap Primary TEP Poor preoperative nutrition Salvage surgery Liver disease, chronic obstructive airways disease, or diabetes Systemic complication in postoperative period |
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