Gastroesophageal reflux prophylaxis decreases the incidence of pharyngocutaneous XXXX after total laryngectomy.

@entity1 @entity33 @entity292 @entity1769 @entity354 @entity5616 @entity130
@entity292 is a serious complication after laryngectomy. Gastric fluid is known to cause severe @entity130 and poor @entity33 . This study was designed to evaluate the effects of a @entity354 prophylaxis regimen on the incidence of @entity292 after laryngectomy. Twenty-one consecutive @entity1 were entered in the study. @entity1 with positive resection margins were excluded from the overall analysis. All @entity1 had a Connell's two-layer closure of the pharynx with absorbable suture, suction drainage of the neck, postoperative tube feeding, and prophylactic antibiotics. All @entity1 were started on an antireflux regimen postoperatively composed of continuous tube feeds, intravenous @entity5616 , and intravenous @entity1769 . @entity1 were followed postoperatively with Gastrografin swallows and clinically for 8 weeks. The control group consisted of retrospectively studied @entity1 managed identically except for the antireflux prophylaxis. The two groups were well matched for factors reported to influence the rate of pharyngocutaneous @entity292 formation. The control group had six fistulae (26%) and an average of 16.5 days of hospital stay. The study group had no fistulae and an average of 11.5 days of hospital stay (P = .02). This study suggests that @entity354 may predispose to @entity292 formation after laryngectomy and that mechanical and pharmacological prophylaxsis decreases postoperative morbidity and length of hospital stay.
