Analysis of decannulation time and oral intake recovery in oral cancer patients

Melgaço, Silmara de Abreu; Vicente, Laelia Cristina Caseiro; Gama, Ana Cristina Côrtes

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Original Article • CoDAS 33 (4) • 2021 • https://doi.org/10.1590/2317-1782/20202019236 copy

Analysis of decannulation time and oral intake recovery in oral cancer patients

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Purpose

to analyze the time of decannulation and oral diet release of patients undergoing oral cancer surgery at the Hospital Alberto Cavalcante and to verify which factors are associated with the time of decannulation and oral diet release.

Methods

an observational study of the database of 33 adult patients surgically treated with oral cancer and served between 2012 and 2017. The socio-demographic variables (age and gender) and clinical variables (type of surgery, surgical extension, type of reconstruction, clinical conditions and times of decannulation and reintroduction of the oral route) were collected through electronic medical records analysis. Descriptive statistical analysis was performed with measures of central tendency, dispersion and proportions. For the association analysis, the non-parametric Mann-Whitney U test was used for independent samples.

Results

of the 33 participants, male and elderly predominated, 69.8% underwent resection of more than one structure. The median time of decannulation among patients with oral cancer was 8 days, and oral clearance of 9.5 days. Resections with more than one structure, the presence of fistula and dehiscence interfered in the oral release time.

Conclusion

the median time of decannulation was eight days and oral release time of 9.5 days. Resections with more than one structure, the presence of fistula, and suture dehiscence are associated with increased oral release time.

Keywords
Oral Neoplasms; Neoplasms of Tongue; Tracheostomy; Glossectomy; Swallowing; Deglutition Disorders; Speech Therapy

Variables	Classification	N	%
Gender	Male	28	84.8
Gender	Female	5	15.2
Age group	Up to 59 years old	14	42.5
Age group	≥60 years old	19	57.5
Age (years old)	Minimum	42
	Maximum	89
	Median	62
	Mean	61.5
	Standard Deviation	12.32
Presence of prior RT	No	33	100
Presence of prior RT	Yes	0	0
Maintaining alertness	Yes	33	100
Maintaining alertness	No	0	0
Presence of respiratory disease	No	30	90.9
Presence of respiratory disease	Yes	3	9.1
Presence of effective cough	Yes	31	93.9
Presence of effective cough	No	2	6.1
Consistency released according to IDDSI	Without OR indication	7	21.2
	0	4	12.1
	2	1	3.0
	3	8	24.2
	4	0	0
	6	0	0
	7	0	0
	0 and 3	12	36.4
	0 and 6	1	3.0

Variables	Classification	N	%
Type of surgery	Pelveglossomandibulectomy	16	48.5
	Glossectomy	7	21.2
	Pelveglossectomy	5	15.2
	Mandibulectomy	2	6.1
	Pelvemandibulectomy	2	6.1
	Palate Resection	1	3
Operative tongue extension	Partial	28	100
Operative tongue extension	Total	0	0
Operative extension of the floor of the mouth	Partial	23	100
Operative extension of the floor of the mouth	Total	0	0
Operative extension of the mandible	Lateral segment	12	60
	Target previous	2	10
	Anterior and lateral segments	2	10
	Marginal	2	10
	Quasitotal	1	3
	Total	1	3
Operative extension of the palate	Partial	1	100
Operative extension of the palate	Total	0	0
Type of reconstruction/tongue suture	Primary	27	96.4
	Regional flap	1	3.6
	Free flap	0	0
	Not done	0	0
Mouth floor reconstruction type	Regional flap	21	100
	Primary	0	0
	Free flap	0	0
	Not done	0	0
Type of jaw reconstruction	Not done	20	100
	Bone free flap	0	0
	Titanium plate	0	0
Type of palate reconstruction	Not done	1	100
	Free flap	0	0
	Blanking Plates	0	0
Presence of neck dissection	Yes	28	84.8
	No	15	15.2
Presence of postoperative fistula	No	27	81.8
	Yes	6	18.2
Presence of suture dehiscence	No	30	90.9
	Yes	3	9.1
Tracheostomy	Yes	24	72.7
	No	9	27.3

Variables	N	Min	Max	Median	Mean	SD	P25	P50	P75
Decannulation time (days)	18	4	140	8.0	24.50	38.80	6.75	8.0	20.3
OR diet release time (days)	26	1	347	9.5	37.00	73.10	3.75	9.5	37.3

		N	Mean	DP	p
Age group	Up to 59 years old	10	24.60	42.03	0.788
Age group	≥60 years old	8	24.37	37.20	0.788
Operative extension	Group 1	5	33.00	59.83	0.427
Operative extension	Group 2	13	21.23	29.96	0.427
Presence of fistula	No	14	19.64	29.23	0.957
Presence of fistula	Yes	4	41.50	65.83	0.957
Presence of dehiscence	No	16	24.00	4.098	0.179
Presence of dehiscence	Yes	2	28.50	19.09	0.179

		N	Mean	DP	p
Age group	Up to 59 years old	11	58.55	105.98	0.466
Age group	≥60 years old	15	21.20	29.78	0.466
Operative extension	Group 1	9	20.44	50.9	0.013
Operative extension	Group 2	17	45.76	82.57	0.013
Presence of fistula	No	21	17.05	26.4	0.011
Presence of fistula	Yes	5	120.80	138.01	0.011
Presence of dehiscence	No	23	35.39	77.75	0.040
Presence of dehiscence	Yes	3	49.33	5.51	0.040

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[1] Conflict of interest: nothing to declare.