Factors associated with gastrostomy tube dependence following salvage total laryngectomy with microvascular free tissue transfer.

Background: Following salvage total laryngectomy (STL) with microvascular‐free tissue transfer (MFTT), patients are at high risk for swallowing dysfunction, but risk factors for persistent gastrostomy tube (G‐tube) dependence are unknown. Methods: Retrospective review of 33 patients who underwent STL with MFTT. Results: A total oral diet was achieved by 81% of patients with ≥6 months of postoperative follow‐up. Approximately 27% of patients were G‐tube dependent preoperatively with 67% achieving a total oral diet postoperatively. Factors associated with persistent G‐tube dependence included pT4 tumor, pN2+ status, more extensive pharyngectomy, and re‐irradiation. Strictures occurred in 30% of patients and were associated with more extensive pharyngectomy and tubed reconstruction. Conclusions: For patients undergoing STL with MFTT, the majority of patients achieve a total oral diet regardless of their preoperative swallowing function. Advanced‐stage recurrent tumors and increased extent of pharyngectomy contribute to poorer swallowing outcomes. [ABSTRACT FROM AUTHOR]