Routine use of salivary bypass tubes in laryngectomy patients: systematic review.

Routine use of salivary bypass tubes in laryngectomy patients: systematic review.

J Laryngol Otol. 2018 Feb 15;:1-5

Authors: Kamhieh Y, Fox H, Hallett E, Berry S

Abstract
BACKGROUND: Pharyngocutaneous fistula is a cause of significant morbidity following laryngectomy. Routine use of salivary bypass tubes during laryngectomy has been proposed to reduce the incidence of fistulae and neopharyngeal strictures.
METHOD: Following a systematic search of Embase, Medline and Cochrane databases (1946 - current), included articles were assessed for bias according to the Cochrane Handbook for Systematic Reviews of Interventions.
RESULTS: Three case-control trials showed reduced pharyngocutaneous fistula rates with the use of salivary bypass tubes; six case series reported widely varied fistula rates. With regards to stricture rates, the largest case-control trial found no improvement with salivary bypass tube use. No fatal adverse events were observed among the 204 patients who received a salivary bypass tube.
CONCLUSION: Low-level evidence suggests salivary bypass tubes may reduce the incidence of fistula in high-risk patient groups. A robust randomised controlled trial, or large, multicentre cohort studies, are needed to further examine this intervention.

PMID: 29444718 [PubMed - as supplied by publisher]

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