Gastrostomy dependence following pharyngolaryngectomy: The effect of preoperative tube insertion.

Abstract

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. 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. 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. 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.