Enhanced recovery after surgery (ERAS) programmes are now well established in many surgical specialities as a means of reducing postoperative complications and length of stay in hospital. Whilst many head and neck teams have interventions used to aid postoperative recovery, formal enhanced recovery programmes following major oncologic head and neck surgery remains a relatively new concept. The article, written by members of the head and neck speech and language therapy team in Sunderland, has a clear speech and language therapy focus, with the following interventions being primarily examined: early oral feeding post laryngectomy and suture closure of tracheal stoma following decannulation in major head and neck resection. The authors found some literature suggesting that early oral feeding post laryngectomy may show promise in reducing length of stay without increased pharyngo-cutaneous fistula rates, and suturing of tracheal stomas after decannulation may reduce time to commencement of oral intake and length of stay. However, the authors highlight clearly the low volume and poor quality of much of the literature on these subjects, and overall, in the head and neck enhanced recovery sphere, making robust conclusions currently impossible.
This article does well to highlight the importance and need for more high-quality research in postoperative enhanced recovery interventions in major head and neck surgery.
However, the relative importance of pre- and intraoperative patient optimisation interventions, which form key parts of many established ERAS programmes employed in other surgical specialities, are not discussed; although these are likely to be more directly transferrable between specialities, such aspects will also need appraisal by any departments considering implementing their own ERAS programme.
