Table of Contents
Advances in Otolaryngology
Volume 2014 (2014), Article ID 420239, 10 pages
http://dx.doi.org/10.1155/2014/420239
Review Article

Early versus Delayed Oral Feeding in Patients following Total Laryngectomy

1ENT Department, Royal Surrey County Hospital, Guildford, Surrey GU2 7XX, UK
2ENT Department, St George’s Hospital, Blackshaw Road, Tooting, London SW17 0QT, UK
3Department of Surgery, Royal Free Campus, University College London, London NW3 2QG, UK

Received 21 July 2014; Accepted 29 August 2014; Published 28 September 2014

Academic Editor: Giuseppe Mercante

Copyright © 2014 Ashley Hay et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objectives. To assess the effects of early oral feeding in laryngectomy patients versus delayed oral feeding. The outcomes used are mortality, pharyngocutaneous fistula rate, quality of life, hospital length of stay, and complications. Method. We performed searches within five major databases until June 2013. We considered randomised control trials (RCTs) and included nonrandomised studies for the assessment of harms. Results. We included four RCTs for assessment of benefits and three nonrandomised studies for assessment of harms (393 participants). There was no statistically significant difference detected in mortality at six months, pharyngocutaneous fistulae, or complications. The length of hospital stay was shorter in the early feeding group, MD −2.72 days [95% CI −5.34 to −0.09]. Conclusion. Early oral feeding appears to have similar incidence of complications and has the potential to shorten the length of hospital stay. Further well-designed RCTs are necessary because of weakness in the available evidence.