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A Journal on Otorhinolaryngology, Head and Neck Surgery,
Plastic Reconstructive Surgery, Otoneurosurgery
Indexed/Abstracted in: EMBASE, Scopus
Otorinolaringologia 2003 June;53(2):55-9
Wound healing after total laryngectomy depending on the way of nutritive drain insertion
Gryczynski M., Morawiec-Bajda A., Pietruszewska W., Pajor A.
Department of Otolaryngology Medical University, Lodz, Poland
Aim. The most recommended and widely-applied method is feeding a patient after total laryngectomy by the nasogastric tube. The authors propose a different way of nourishing patients using the drain which is put just through the upper pole of the neck wound during laryngectomy. Incidence of pharyngocutaneous fistulas after total laryngectomy was evaluated according to the method of nutritive drain insertion.
Methods. The study was performed in 464 patients (64% of all laryngectomized) treated surgically at the ENT Department of the Medical University in Lodz from 1988 to 1997. Pharyngocutaneous fistulas developed in 114 cases (24.6%). Two groups of patients following laryngectomy were analyzed: the 1st consisted of 279 patients with nasogastric tube and the 2nd group numbered 163 subjects with drain put through the neck wound.
Results. The most dangerous complication as pharyngocutaneous fistulas developed statistically rarely in the group with the drain inserted by the neck wound than in the group with nasogastric tube (17.8% vs 27.9%, p<0.05). Moreover patients in the 2nd group did not suffer from the unpleasant pain in the nose, and more easily accepted this manner of nutrition.
Conclusions. Satisfactory surgical results of wound healing and positive psychological and aesthetic aspects for the patients and their environment confirm the usefulness of the different method of insertion of the nutritive drain by the neck wound.