Surgical management of gastroesophageal reflux and outcome after laryngectomy in patients using tracheoesophageal speech

Am J Surg. 2002 May;183(5):539-43. doi: 10.1016/s0002-9610(02)00828-0.

Abstract

Background: Gastroesophageal reflux disease (GERD) is common in patients with head and neck carcinoma. The impact of laparoscopic fundoplication on laryngectomy patients with tracheoesophageal prostheses for voice restoration is unknown.

Methods: Nine laryngectomy patients who use tracheoesophageal speech underwent laparoscopic fundoplication for documented reflux. Preoperative and postoperative symptoms were recorded. Quality of speech was documented before and after fundoplication.

Results: Although 88% of patients had resolution of GERD symptoms, all developed bloating and hyperflatulence. There was no difference in quality of esophageal speech after laparoscopic fundoplication.

Conclusions: Fundoplication in laryngectomy patients that use tracheoesophageal speech eliminates symptoms of gastroesophageal reflux and resolves regurgitation associated prosthesis erosion. Although nearly all patients are satisfied with outcome, there is a high incidence of postfundoplication bloating and hyperflatulence that may be life limiting. Poor quality tracheoesophageal speech should not be used as an indication for antireflux surgery.

MeSH terms

  • Aged
  • Carcinoma, Squamous Cell / complications
  • Carcinoma, Squamous Cell / surgery*
  • Female
  • Flatulence / etiology
  • Fundoplication* / adverse effects
  • Gastroesophageal Reflux / complications
  • Gastroesophageal Reflux / surgery*
  • Humans
  • Intestines / physiopathology
  • Laparoscopy / adverse effects
  • Laryngectomy* / adverse effects
  • Male
  • Middle Aged
  • Otorhinolaryngologic Neoplasms / complications
  • Otorhinolaryngologic Neoplasms / surgery*
  • Patient Satisfaction
  • Quality of Life
  • Retrospective Studies
  • Speech, Esophageal*
  • Treatment Outcome