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Transcutaneous cervical miniesophagostomy

G Har-El1, A N Balwally

  • 1Department of Otolaryngology, State University of New York Health Science Center at Brooklyn, USA.

Otolaryngology--Head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery
|October 1, 1995
PubMed
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Nasogastric tubes can harm the throat after laryngeal surgery. Transcutaneous cervical miniesophagostomy offers a safe, simple alternative for feeding tube placement, minimizing complications and aiding recovery.

Area of Science:

  • Otolaryngology
  • Surgical Oncology
  • Gastroenterology

Background:

  • Nasogastric tubes can cause pharyngolaryngeal injury, including inflammation and vocal cord immobility.
  • Co-placement of nasogastric and tracheotomy tubes post-laryngeal surgery exacerbates laryngeal damage, delaying healing and decannulation.
  • Percutaneous endoscopic gastrostomy is an alternative but requires specialized resources and inter-service collaboration.

Purpose of the Study:

  • To evaluate the safety and efficacy of transcutaneous cervical miniesophagostomy (TCM) as a feeding access method during conservation laryngeal and/or pharyngeal surgery.
  • To present the authors' experience with TCM in a series of patients undergoing head and neck cancer surgery.
  • To establish TCM as a simple, rapid, and low-morbidity alternative to traditional feeding tube placements.

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Main Methods:

  • Seventeen patients undergoing conservation laryngeal and/or pharyngeal surgery received TCM with a small-caliber feeding tube.
  • The procedure was performed by head and neck surgeons during the primary cancer surgery.
  • Complications were tracked and analyzed based on tube-days.

Main Results:

  • A low rate of minor complications (11.7%, 0.40 per 100 tube days) was observed.
  • No major complications were associated with the TCM procedure.
  • The procedure was technically simple, taking approximately 5 minutes, and performed with minimal postoperative morbidity when funneling under skin flaps was utilized.

Conclusions:

  • Transcutaneous cervical miniesophagostomy is a safe, simple, and quick procedure for feeding access during head and neck cancer surgery.
  • TCM can be performed by head and neck surgeons without requiring specialized expertise or extensive resources.
  • This technique minimizes postoperative morbidity and facilitates patient recovery, offering a valuable alternative to other feeding methods.