Dear colleagues,

Definitive or salvage total laryngectomy (TL) remains important in the therapeutic algorithm of advanced laryngeal and hypopharyngeal cancer, despite an increase in organ preservation protocols. However, the post-operative management of these patients remains controversial, especially with regards to the initiation of oral feeds. The practice of early oral feeding following TL is not widely accepted despite increasing evidence in support thereof.

The YO-IFOS (www.yoifos.com) would like to explore post-operative management of TL patients regarding oral intake in institutions around the world. We invite you to participate to this survey in order to share the protocol used at your center. Data of the survey will be compiled electronically and anonymously using a database.

The duration of the survey should be approximately 10 minutes. You can select several answers for each question.

We thank you for your participation in this survey.

Best regards,

Nicolas Fakhry, President of YO-IFOS
Tareck Ayad, Chairman of the YO-IFOS research Committee
Johanna Benali
 
A. General information

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* 2. In which city ?

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* 3. In which institution ?

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* 4. What kind of medical facility do you work in ?

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* 5. How many total laryngectomies or laryngopharyngectomies are performed every year at your department ?

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* 6. What proportion of total laryngectomies or laryngopharyngectomies performed at your institution are salvage surgeries after radio (chemo) therapy ?

B. Patients nutritional status

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* 7. How do you usually assess your patients’ nutritional status before surgery ?

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* 8. Do you usually work as a team with a dietician/nutritionist for the nutritional management of your patients ?

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* 9. What kind of nutritional support do you usually use during the post-operative period ?

C. For a patient who underwent total laryngectomy without pharyngectomy and without prior radiotherapy and with primary mucosal closure : 

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* 10. When do you start oral hydration (water)?

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* 11. If no complication occurs, when do you start oral feeding with liquid diet (juice, milk…)?

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* 12. If no complication occurs, when do you start oral feeding with semi solid food (mixed, puree)?

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* 13. If no complication occurs, when do you start oral feeding with free diet ?

D. For a patient who underwent a salvage laryngectomy after prior radiotherapy, without pharyngectomy and with primary mucosal closure:

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* 14. When do you start oral hydration (water) ?

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* 15. If no complication occurs, when do you start oral feeding with liquid diet (juice, milk…)

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* 16. If no complication occurs, when do you start oral feeding with semi solid food (mixed, puree) ?

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* 17. If no complication occurs, when do you start oral feeding with free diet ?

E. For a patient who underwent total laryngectomy associated with pharyngectomy (total laryngopharyngectomy) for a tumor involving the hypopharynx, and without prior radiotherapy with the use a pediculed or free flap for reconstruction of mucosal defect of the pharynx:

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* 18. When do you start oral hydration (water) ?

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* 19. If no complication occurs, when do you start oral feeding with liquid diet (juice, milk…)

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* 20. If no complication occurs, when do you start oral feeding with semi solid food (mixed, puree) ?

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* 21. If no complication occurs, when do you start oral feeding with free diet ?

F. For a patient who underwent salvage total laryngectomy associated with pharyngectomy (total laryngopharyngectomy) for a tumor involving the hypopharynx, after prior radiotherapy with the use a pediculed or free flap for reconstruction of mucosal defect of the pharynx:

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* 22. When do you start oral hydration (water) ?

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* 23. If no complication occurs, when do you start oral feeding with liquid diet (juice, milk…)

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* 24. If no complication occurs, when do you start oral feeding with semi solid food ?

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* 25. If no complication occurs, when do you start oral feeding with free diet ?

G. Other

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* 26. For a patient who underwent total laryngectomy without pharyngectomy and without prior radiotherapy, which technique do you use for primary mucosal closure?

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* 27. What is the estimated pharyngocutaneous fistula rate at your institution (overall estimation including all your procedures)?

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* 28. Which method do you usually use to ensure the absence of pharyngocutaneous fistula before allowing oral intakes ?

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* 29. In case of blue methylene test or barium swallow test, when do you perform it (If no complication occurs)?

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* 30. Which other elements can lead you to systematically postpone oral intake after total laryngectomy or laryngopharyngectomy, even in the absence of postoperative complication ?

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* 31. For a patient without complication, what is the average length of hospital stay after total laryngectomy at your institution ?

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* 32. Comments

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* 33. Please provide your email address (optional)

Once you have reviewed all the questions, please click "Done" button to finalize your contribution

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