Functional Outcomes and Nutrition in Patients Undergoing Pharyngo‐Laryngo‐Esophagectomy with Laparoscopic Gastric Transposition. (23rd August 2013)

• Record Type: Journal Article
• Authors: Watson, Natalie A.; Garcia, Donna; Hughes, Rhys; Sullivan, Allana; Ballis, Sarah; Wade‐McBane, Kelly; Lee, Michael S. W.
• Is Part Of: Otolaryngology--head and neck surgery. Volume 149(2013)Supplement 2
• Page Start: P173
• Page End: P173
• Publication Date: 2013-08-23
• Subjects: Head -- Surgery -- Periodicals; Neck -- Surgery -- Periodicals; Otolaryngology -- Periodicals; 617.51
• DOI: 10.1177/0194599813496044a94
• Languages: English
• ISSNs: 0194-5998

Abstract

Abstract : Objectives: Explore functional outcomes and nutrition in patients undergoing pharyngo‐laryngo‐esophagectomy with laparoscopic gastric transposition. Methods: A retrospective case‐note review of patients who have undergone pharyngo‐laryngo‐esophagectomy with laparoscopic gastric transposition for squamous cell carcinoma of the hypopharynx between 1/2/2010 and 31/1/2013 at a tertiary referral center. History, anthropometrics, length of admission, biochemical markers, nutritional requirements, provision, complications, readmission, pre‐operative voice quality, timeframes to secondary TOP, perceptual measures of TOP speech, normalcy of diet and public eating performance status score were collated. Results: Eight patients, mean age of 55 at operation. Voice outcome: The timeframe from surgery to completion of a secondary puncture was approximately one calendar year. One patient has functional hypotonic voice 3 years post‐op. Nutrition: Pre‐operative nutritional support was inconsistent. Patients had a jejunal (JEJ) feeding tube inserted at the time of surgery. Post‐operatively patients were nil by mouth with JEJ feeding being commenced between day 1 and 12. Mean body mass index at 6 months and 3 years 20.8kg/m2 and 19.65 kg/m2 (latter in 2 patients of 3 survivors). Swallowing: Mean pre‐operative PSS scores for normalcy of diet and public eating were 30/100 and 50/100 respectively. Dysphagia was an issue for all patients post‐operatively with none achieving normalcy of diet PSS levels >50/100. Following surgery compared with pre‐operative scores, all public‐eating scores reduced. Conclusions: Voice restoration and swallowing functions are reduced following surgery. Pre‐ and post‐operative nutritional support is essential. We believe our experience over 3 years is the longest and largest case series review of functional outcomes worldwide.