Oral feeding following laryngectomy: early or delayed?

A best evidence topic in otolaryngology was written according to a structured protocol. The question addressed was: In patients having undergone laryngectomy, does the timing of oral feeding lead to a higher post-operative complication rate? 172 papers were found using the described protocol. Five of these papers were chosen to describe the best evidence to address the question. The authors, date and country of publication, study type, patient group, outcomes and key results of these papers have been represented in a table. All of these studies demonstrate that initiation of early feeding in patients post-laryngectomy provides no increased risk of development of pharyngocutaneous fistulas than delayed initiation of feeding. One study demonstrated a statistically significant reduction in hospitalisation of patients after early post-operative feeding. Therefore despite problems with study design, the literature concludes that early feeding is as safe as delayed feeding and may reduce the hospitalisation period. Further powered studies are required before recommendations on explicit inclusion criteria and feeding regimen details can be made.