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Timing of postoperative oral feeding after head and neck mucosal free flap reconstruction

OBJECTIVE: Fistula remains a common complication of upper aerodigestive tract reconstruction. Optimal timing of oral feeding is unknown and the impact of early feeding on swallow function and fistula rates remains controversial. The purpose of this study is to better understand the effects of “early...

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Autores principales: Stramiello, Joshua, Nuyen, Brian, Saraswathula, Anirudh, Blumenfeld, Liza, Divi, Vasu, Rosenthal, Eben, Orosco, Ryan, Starmer, Heather M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley & Sons, Inc. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8513441/
https://www.ncbi.nlm.nih.gov/pubmed/34667846
http://dx.doi.org/10.1002/lio2.655
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author Stramiello, Joshua
Nuyen, Brian
Saraswathula, Anirudh
Blumenfeld, Liza
Divi, Vasu
Rosenthal, Eben
Orosco, Ryan
Starmer, Heather M.
author_facet Stramiello, Joshua
Nuyen, Brian
Saraswathula, Anirudh
Blumenfeld, Liza
Divi, Vasu
Rosenthal, Eben
Orosco, Ryan
Starmer, Heather M.
author_sort Stramiello, Joshua
collection PubMed
description OBJECTIVE: Fistula remains a common complication of upper aerodigestive tract reconstruction. Optimal timing of oral feeding is unknown and the impact of early feeding on swallow function and fistula rates remains controversial. The purpose of this study is to better understand the effects of “early feeding” on fistula rate and swallow in patients with free flap reconstruction of upper aerodigestive tract defects. METHODS: Retrospective cohort study. One hundred and four patients undergoing free flap reconstruction of mucosalized head and neck defects. Two groups, early feeding (oral intake on or before postoperative day 5) and late‐feeding (oral intake after postoperative day 5). Primary outcome was incidence of salivary fistula. Secondary outcomes included Functional Oral Intake Scale scores. RESULTS: Fistula rate was 16.5% in late‐feeding group and 0% in early‐feeding group (P = .035). Patients who were fed early had an association with progression to a full oral diet by 30 days (P = .027). DISCUSSION: This cohort analysis suggests that in properly selected patients with free flap reconstruction for mucosal defects, early feeding may not increase risk of salivary fistula and may improve swallow functional outcomes earlier. Level of Evidence: 3
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spelling pubmed-85134412021-10-18 Timing of postoperative oral feeding after head and neck mucosal free flap reconstruction Stramiello, Joshua Nuyen, Brian Saraswathula, Anirudh Blumenfeld, Liza Divi, Vasu Rosenthal, Eben Orosco, Ryan Starmer, Heather M. Laryngoscope Investig Otolaryngol Head and Neck, and Tumor Biology OBJECTIVE: Fistula remains a common complication of upper aerodigestive tract reconstruction. Optimal timing of oral feeding is unknown and the impact of early feeding on swallow function and fistula rates remains controversial. The purpose of this study is to better understand the effects of “early feeding” on fistula rate and swallow in patients with free flap reconstruction of upper aerodigestive tract defects. METHODS: Retrospective cohort study. One hundred and four patients undergoing free flap reconstruction of mucosalized head and neck defects. Two groups, early feeding (oral intake on or before postoperative day 5) and late‐feeding (oral intake after postoperative day 5). Primary outcome was incidence of salivary fistula. Secondary outcomes included Functional Oral Intake Scale scores. RESULTS: Fistula rate was 16.5% in late‐feeding group and 0% in early‐feeding group (P = .035). Patients who were fed early had an association with progression to a full oral diet by 30 days (P = .027). DISCUSSION: This cohort analysis suggests that in properly selected patients with free flap reconstruction for mucosal defects, early feeding may not increase risk of salivary fistula and may improve swallow functional outcomes earlier. Level of Evidence: 3 John Wiley & Sons, Inc. 2021-09-09 /pmc/articles/PMC8513441/ /pubmed/34667846 http://dx.doi.org/10.1002/lio2.655 Text en © 2021 The Authors. Laryngoscope Investigative Otolaryngology published by Wiley Periodicals LLC on behalf of The Triological Society. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Head and Neck, and Tumor Biology
Stramiello, Joshua
Nuyen, Brian
Saraswathula, Anirudh
Blumenfeld, Liza
Divi, Vasu
Rosenthal, Eben
Orosco, Ryan
Starmer, Heather M.
Timing of postoperative oral feeding after head and neck mucosal free flap reconstruction
title Timing of postoperative oral feeding after head and neck mucosal free flap reconstruction
title_full Timing of postoperative oral feeding after head and neck mucosal free flap reconstruction
title_fullStr Timing of postoperative oral feeding after head and neck mucosal free flap reconstruction
title_full_unstemmed Timing of postoperative oral feeding after head and neck mucosal free flap reconstruction
title_short Timing of postoperative oral feeding after head and neck mucosal free flap reconstruction
title_sort timing of postoperative oral feeding after head and neck mucosal free flap reconstruction
topic Head and Neck, and Tumor Biology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8513441/
https://www.ncbi.nlm.nih.gov/pubmed/34667846
http://dx.doi.org/10.1002/lio2.655
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