Water soluble swallow for leak detection after total laryngectomy post radiotherapy.
Pharyngeal leak
Pharyngocutaneous fistula
Salvage laryngectomy
Water soluble swallow
Journal
European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery
ISSN: 1434-4726
Titre abrégé: Eur Arch Otorhinolaryngol
Pays: Germany
ID NLM: 9002937
Informations de publication
Date de publication:
Sep 2023
Sep 2023
Historique:
received:
16
01
2023
accepted:
08
05
2023
medline:
31
7
2023
pubmed:
21
5
2023
entrez:
20
5
2023
Statut:
ppublish
Résumé
Pharyngeal leak (PL) and pharyngocutaneous fistula (PCF) are serious complications following total laryngectomy and their incidence is higher in the salvage setting. The aim of this study is to describe the accuracy of water soluble swallow (WSS) to rule out salivary postoperative leak after salvage total laryngectomy (STL) to expedite start of oral intake. Retrospective study including patients undergoing STL between 2008 and 2021 at Guy's Hospital. WSS was routinely performed within 15 days post operation. Sixty-six patients underwent STL. Nine developed clinically diagnosed PCF; one died before having WSS. Fifty-six patients underwent WSS post STL. WSS was performed within 15 days after STL when no postoperative complications occurred (76.8%). Among patients undergoing WSS with no clinical suspicion for fistula (56), PL was identified in 15 cases (26.8%). They were managed conservatively; PCF was avoided in 7(46.7%) cases. Three patients (7.3%) developed PCF after having started oral intake with a negative WSS. These three cases were further analysed, 2 cases where recorded at the beginning of the studied period when less experience was available possibly leading to incorrect results. Sensitivity and negative predictive value (NPV) for fistula prediction were 72.7% and 92.7%, respectively. Taking into account the high NPV of WSS, it is safe to start oral intake after negative WSS. Further studies to evaluate its accuracy earlier on after SLT are justified taking into account the results and the impact that delayed feeding has on patient's quality of life.
Identifiants
pubmed: 37210463
doi: 10.1007/s00405-023-08016-7
pii: 10.1007/s00405-023-08016-7
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
4225-4232Informations de copyright
© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
Références
Paydarfar JA, Birkmeyer NJ (2006) Complications in head and neck surgery: a meta-analysis of postlaryngectomy pharyngocutaneous fistula. Arch Otolaryngol Head Neck Surg 132(1):67–72. https://doi.org/10.1001/archotol.132.1.67
doi: 10.1001/archotol.132.1.67
pubmed: 16415432
Rovira A, Tornero J, Oliva M, Taberna M, Montal R, Nogues J, Farre A, Lares H, Navarro V, Mari A, Vinals JM, Lozano A, Mesia R, Manos M (2017) Salvage surgery after head and neck squamous cell carcinoma treated with bioradiotherapy. Head Neck 39(1):116–121. https://doi.org/10.1002/hed.24549
doi: 10.1002/hed.24549
pubmed: 27459296
Department of Veterans Affairs Laryngeal Cancer Study Group, Wolf GT, Gross Fisher S, Ki Hong W, Hillman R, Spaulding M, Laramore GE, Endicott JW, McClatchey K, Henderson WG (1991) Induction chemotherapy plus radiation compared with surgery plus radiation in patients with advanced laryngeal cancer. N Engl J Med 324(24):1685–1690. https://doi.org/10.1056/nejm199106133242402
doi: 10.1056/nejm199106133242402
Qureshi SS, Chaturvedi P, Pai PS, Chaukar DA, Deshpande MS, Pathak KA, D’cruz JAK (2005) A prospective study of pharyngocutaneous fistulas following total laryngectomy. Cancer Res Ther 1(1):51–56. https://doi.org/10.4103/0973-1482.16092
doi: 10.4103/0973-1482.16092
Saydam L, Kalcioglu T, Kizilay A (2002) Early oral feeding following total laryngectomy. Am J Otolaryngol 23(5):277–281. https://doi.org/10.1053/ajot.2002.126321
doi: 10.1053/ajot.2002.126321
pubmed: 12239692
Eustaquio M, Medina JE, Krempl GA, Hales N (2009) Early oral feeding after salvage laryngectomy. Head Neck 31(10):1341–1345. https://doi.org/10.1002/hed.21098
doi: 10.1002/hed.21098
pubmed: 19373787
Hasan Z, Dwivedi RC, Gunaratne DA, Virk SA, Palme CE, Riffat F (2017) Systematic review and meta-analysis of the complications of salvage total laryngectomy. Eur J Surg Oncol 43(1):42–51. https://doi.org/10.1016/j.ejso.2016.05.017
doi: 10.1016/j.ejso.2016.05.017
pubmed: 27265037
Moses BL, Eisele DW, Jones B (1993) Radiologic assessment of the early postoperative total-laryngectomy patient. Laryngoscope 103:1157–1160. https://doi.org/10.1288/00005537-199310000-00014
doi: 10.1288/00005537-199310000-00014
pubmed: 8412454
Narayan M, Limbachiya S, Balasubramanian D, Subramaniam N, Thankappan K, Iyer S (2020) Efficacy of small-volume gastrografin videofluoroscopic screening for detecting pharyngeal leaks following total laryngectomy. J Laryngol Otol 134(4):350–353. https://doi.org/10.1017/s0022215120000596
doi: 10.1017/s0022215120000596
pubmed: 32172698
Van la Parra RFD, Kon M, Schellekens PPA, Braunius WW, Pameijer FA (2007) The prognostic value of abnormal findings on radiographic swallowing studies after total laryngectomy. Cancer Imaging 7(1):119–125. https://doi.org/10.1102/1470-7330.2007.0015
doi: 10.1102/1470-7330.2007.0015
pubmed: 17562591
Krouse JH, Metson R (1992) Barium swallow is a predictor of salivary fistula following laryngectomy. Otolaryngol Head Neck Surg 106(3):254–257. https://doi.org/10.1177/019459989210600310
doi: 10.1177/019459989210600310
pubmed: 1589217
Vessal K, Montali RJ, Larson SM, Chaffee V, James AE Jr (1975) Evaluation of barium and gastrografin as contrast media for the diagnosis of esophageal ruptures or perforations. Am J Roentgenol Radium Ther Nucl Med 123(2):307–319. https://doi.org/10.2214/ajr.123.2.307
doi: 10.2214/ajr.123.2.307
pubmed: 1115308
Franquet T, Giménez A, Rosón N, Torrubia S, Sabaté JM, Pérez C (2000) Aspiration diseases: findings, pitfalls, and differential diagnosis. Radiographics 20(3):673–685. https://doi.org/10.1148/radiographics.20.3.g00ma01673
doi: 10.1148/radiographics.20.3.g00ma01673
pubmed: 10835120
Federle MP, Jaffe TA, Davis PL, Al-Hawary MM, Levine MS (2017) Contrast media for fluoroscopic examinations of the GI and GU tracts: current challenges and recommendations. Abdom Radiol (NY) 42(1):90–100. https://doi.org/10.1007/s00261-016-0861-1
doi: 10.1007/s00261-016-0861-1
pubmed: 27503380
Berry BE, Ochsner JL (1973) Perforation of the esophagus: a 30 year review. J Thorac Cardiovasc Surg 65:1–7
doi: 10.1016/S0022-5223(19)40817-9
pubmed: 4682465
Tanomkiat W, Galassi W (2000) Barium sulfate as contrast medium for evaluation of postoperative anastomotic leaks. Acta Radiol 41(5):482–485. https://doi.org/10.1080/028418500127345730
doi: 10.1080/028418500127345730
pubmed: 11016771
Kim HM, Choi KH, Kim TW (2013) Patients’ radiation dose during videofluoroscopic swallowing studies according to underlying characteristics. Dysphagia 28(2):153–158. https://doi.org/10.1007/s00455-012-9424-y
doi: 10.1007/s00455-012-9424-y
pubmed: 22961462
Smith-Bindman R, Lipson J, Marcus R, Kim KP, Mahesh M, Robert Gould R, Berrington de González A, Miglioretti DL (2009) Radiation dose associated with common computed tomography examinations and the associated lifetime attributable risk of cancer. Arch Intern Med 169(22):2078–2086. https://doi.org/10.1001/archinternmed.2009.427
doi: 10.1001/archinternmed.2009.427
pubmed: 20008690
pmcid: 4635397
Strauss C, Mal F, Perniceni T, Bouzar N, Lenoir S, Gayet B, Palau R (2010) Computed tomography versus water-soluble contrast swallow in the detection of intrathoracic anastomotic leak complicating esophagogastrectomy (Ivor Lewis): a prospective study in 97 patients. Ann Surg 251(4):647–651. https://doi.org/10.1097/sla.0b013e3181c1aeb8
doi: 10.1097/sla.0b013e3181c1aeb8
pubmed: 19864934
Upponi S, Ganeshan A, D’Costa H, Betts M, Maynard N, Bungay H, Slater A (2014) Radiological detection of post-oesophagectomy anastomotic leak - a comparison between multidetector CT and fluoroscopy. Br J Radiol 81(967):545–548. https://doi.org/10.1259/bjr/30515892
doi: 10.1259/bjr/30515892
Ahn D, Lee GJ, Sohn JH (2019) Ultrasonographic swallowing examination for early detection of neopharyngeal fistula after salvage total laryngectomy: a preliminary study. Head Neck 41(6):1804–1808. https://doi.org/10.1002/hed.25617
doi: 10.1002/hed.25617
pubmed: 30676670
Iteld L, Yu P (2007) Pharyngocutaneous fistula repair after radiotherapy and salvage total laryngectomy. J Reconstr Microsurg 23(6):339–345. https://doi.org/10.1055/s-2007-992343
doi: 10.1055/s-2007-992343
pubmed: 17979066
Yu P, Hanasono MM, Skoracki RJ, Baumann DP, Lewin JS, Weber RS, Robb GL (2010) Pharyngoesophageal reconstruction with the anterolateral thigh flap after total laryngopharyngectomy. Cancer 116(7):1718–1724. https://doi.org/10.1002/cncr.24947
doi: 10.1002/cncr.24947
pubmed: 20120029
Aprigliano F (1990) Use of the nasogastric tube after total laryngectomy: is it truly necessary? Ann Otol Rhinol Laryngol 99(7 Pt 1):513–514. https://doi.org/10.1177/000348949009900703
doi: 10.1177/000348949009900703
pubmed: 2195958
Süslü N, Hoşal AS (2016) Early oral feeding after total laryngectomy: outcome of 602 patients in one cancer center. Auris Nasus Larynx 43(5):546–550. https://doi.org/10.1016/j.anl.2016.01.004
doi: 10.1016/j.anl.2016.01.004
pubmed: 26908188
Sousa AA, Porcaro-Salles JM, Soares JMA, de Moraes GM, Silva GS, Sepulcri RA, Savassi-Rocha PR (2014) Does early oral feeding increase the likelihood of salivary fistula after total laryngectomy? J Laryngol Otol 15:1–7. https://doi.org/10.1017/s0022215114000747
doi: 10.1017/s0022215114000747
Serbanescu-Kele CMC, Halmos GB, Wedman J, van der Laan BFAM, Plaat BEC (2015) Early feeding after total laryngectomy results in shorter hospital stay without increased risk of complications: a retrospective case-control study. Clin Otolaryngol 40(6):587–592. https://doi.org/10.1111/coa.12420
doi: 10.1111/coa.12420
pubmed: 25816718
Bulğurcu S, Çukurova I (2018) Comparison of early versus delayed oral feeding after total laryngectomy in terms of pharyngocutaneous fistula development. Turk Arch Otorhinolaryngol 56(4):217–220
doi: 10.5152/tao.2018.3605
pubmed: 30701117
pmcid: 6340318
Timmermans AJ, Lansaat L, Kroon GVJ, Hamming-Vrieze O, Hilgers FJM, van den Brekel MWM (2014) Early oral intake after total laryngectomy does not increase pharyngocutaneous fistulisation. Eur Arch Otorhinolaryngol 271(2):353–358. https://doi.org/10.1007/s00405-013-2524-y
doi: 10.1007/s00405-013-2524-y
pubmed: 23625389
Le Flem M, Santini L, Boulze C, Alshukry A, Giovanni A, Dessi P, Fakhry N (2020) Early oral hydration protects against pharyngocutaneous fistula after total laryngectomy or total pharyngolaryngectomy. Head Neck 42(8):1902–1906. https://doi.org/10.1002/hed.26122
doi: 10.1002/hed.26122
pubmed: 32125034
White HN, Golden B, Sweeny L, Carroll WR, Magnuson JS, Rosenthal EL (2012) Assessment and incidence of salivary leak following laryngectomy. Laryngoscope 122(8):1796–1799. https://doi.org/10.1002/lary.23443
doi: 10.1002/lary.23443
pubmed: 22648757
pmcid: 3951314
Cordeiro PG, Shah K, Santamaria E, Gollub MJ, Singh B, Shah JP (1999) Barium swallows after free jejunal transfer: should they be performed routinely? Plast Reconstr Surg 103(4):1167–1175. https://doi.org/10.1097/00006534-199904040-00010
doi: 10.1097/00006534-199904040-00010
pubmed: 10088502