The effect of early oral feeding compared to standard oral feeding following total laryngectomy: a systematic review.

Abstract

Review question/objective The objective of this review is to identify and synthesise the best available evidence on effects of early feeding compared to standard oral feeding following total laryngectomy on the incidence of pharyngocutaneous fistula and hospital length of stay.More specifically, the review questions are: What is the effect of early oral feeding following total laryngectomy on the incidence of post-operative pharyngocutaneous fistula? What is the effect of early oral feeding following total laryngectomy on hospital length of stay? Inclusion criteria Types of participants This review will consider studies that include adults (18 years old or older) regardless of gender and co-morbidities who have commenced early oral feeding following total laryngectomy surgery. Studies focussing on enteral feeding will be excluded from this review. Types of interventions This review will consider studies that evaluate oral feeding following total laryngectomy. The intervention of interest is early oral feeding defined as oral intake in the first 6 days post-operatively. The comparator is standard care and is defined as oral intake from day 7 onwards. For the purpose of this review, oral feeding will include either food or liquid taken by mouth regardless of quantity or consistency. Oral feeding may be taken in conjunction with non oral nutrition. Types of outcomes This review will consider studies that include the following outcome measure: incidence of pharyngocutaneous fistula. In the context of this review, the term incidence refers to the number of new cases of pharyngocutaneous fistula within 6 months following total laryngectomy surgery. A further outcome may include but will not be limited to hospital length of stay measured as days of hospital inpatient admission.