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The formulation of an enhanced recovery programme for patients undergoing laryngectomy

Part of: JLO Editors' Choice Papers 2022

Published online by Cambridge University Press:  10 February 2022

G Wilson Open the ORCID record for G Wilson [Opens in a new window] ,
M Nistor  and
N Beasley
G Wilson*
Affiliation:
Department of Otolaryngology, Queen's Medical Centre, Nottingham, UK
M Nistor
Affiliation:
Health Education East Midlands General Practice training rotation, UK
N Beasley
Affiliation:
Department of Otolaryngology, Royal Hallamshire Hospital, Sheffield, UK
*
Author for correspondence: Dr G Wilson, Queen's Medical Centre, Derby Road, NottinghamNG7 2UE, UK E-mail: gemmachristinawilson@gmail.com
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Abstract

Objective

Enhanced recovery programmes have been widely adopted in other surgical disciplines but are not commonplace in head and neck surgery. The authors of this study created a pathway for post-operative laryngectomy patients.

Method

A multidisciplinary working group reviewed the literature and agreed standards of care. A retrospective audit was conducted to measure current practice against our new pathway; after programme implementation our performance was reaudited in two prospective cycles, with an education programme and review after the first prospective cycle.

Results

Statistically significant improvement in performance was realised in catheter and surgical drain removal, opiate analgesia use, mobilisation, and timeliness of swallow assessment. The rate of hospital acquired pneumonia reduced from 23.1 to 9.5 per cent and length of stay reduced by a median of 5.2 days to 14.8 days (non-significant).

Conclusion

The programme improved consistency of patient care across most areas that were measured. Improving patient stoma training needs to be prioritised.

Keywords

LaryngectomySurgeryOtolaryngologic Surgical ProceduresLaryngeal NeoplasmsOtolaryngologic Diseases
Type
Main Article
Information
The Journal of Laryngology & Otology , Volume 136 , Issue 9 , September 2022 , pp. 848 - 860
Copyright
Copyright © The Author(s), 2022. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

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Footnotes

Dr G Wilson takes responsibility for the integrity of the content of the paper

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