Is Prophylactic Feeding Tube Placement Necessary for Transoral Robotic Surgery Patients?

Sunday, October 12, 2025

1:42 PM - 1:48 PM EDT

Location: 127

Disclosure(s):

Lauren K. Storm, BS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Prophylactic feeding tube (FT) placement during transoral robotic surgery (TORS) for oropharyngeal squamous cell carcinoma (OPSCC) patients remain debated and there is great variability between surgeon practices. We seek to evaluate weight and diet outcomes in a practice that does not prophylactically place feeding tubes and to analyze factors leading to placement.

Methods: An IRB approved retrospective chart review was performed at a tertiary care academic center of adult patients undergoing TORS for OPSCC from 2020-2024. Data collection included patient demographics, cancer characteristics, pre- and post-operative weights, dysphagia, diet, and speech language pathologist (SLP) visits. Analysis was performed.

Results: Of 92 patients, average age was 60.43 years and majority of patients were White (77.2%) and male (75%). Majority were primary cases (95.7%) versus salvage (4.3%), primary tonsil subsite (45.7%) and 70.7% were stage I. Patients had an average of 2.57 SLP visits. Regarding FT placement, 87.0% did not require, 1.1% had placed intra-operatively, 2.2% post-operative, and 9.8% during treatment. Average percent weight change was calculated for post operative visits (POVs). Average weight change was 3.49% decrease from baseline at POV#1 and 3.65% decrease at POV#2. By adjuvant treatment start, average weight change from baseline was an increase of 0.61%, however, there was an average decrease of 7.26% by adjuvant treatment end. Greater percentage weight changes found for salvage patients at POV #1 (p=0.006) and #2 (p=0.045) and patients with higher Charlson Comorbidity Index at POV #1 (p=0.024) and #2 (p=0.014). With increase in age, the odds of FT placement during treatment increased (OR=1.097, p=0.032, CI [1.008,1.194]). Most patients were on regular or soft diet post-treatment (60.8% and 15.2%).

Conclusions: Avoiding prophylactic FT placement is safe for the majority of TORS patients. Most were able to progress to a solid diet with minimal temporary weight loss. FT could be considered on a case-by-case basis with SLP guidance.

Presenting Author(s)

Lauren K. Storm, BS

Mrs. Lauren Kate Storm
University of Mississippi Medical Center School of Medicine
Ridgeland, MS, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Co-Author(s)

Brian L. Driskill, MD

Dr. Brian L. Driskill
University of Mississippi Medical Center, Department of Otolaryngology Head and Neck Surgery
jackson, MS, United States

Disclosure information not submitted.
MM

Mary Caroline McGraw, M.S. CCC-SLP BCS-S

Mrs. Mary Caroline McGraw
University of Mississippi Medical Center, Department of Otolaryngology Head and Neck Surgery
Madison, Mississippi, United States

Disclosure information not submitted.
PS

Paige G. Sanford, M.S. CCC-SLP

Mrs. Paige G. Sanford
University of Mississippi Medical Center, Department of Otolaryngology Head and Neck Surgery, United States

Disclosure information not submitted.
OP

Oishika Paul, MPH

University of Mississippi Medical Center, Department of Otolaryngology Head and Neck Surgery, United States

Disclosure information not submitted.

Senior Author(s)

Anne C. Kane, MD FACS

Associate Professor
University of Alabama - Birmingham, Department of Otolaryngology Head and Neck Surgery
Birmingham, AL, United States

Disclosure information not submitted.