Summary of the best evidence for the prevention and management of postoperative tracheostomy complications in laryngeal cancer patients

Introduction This study aimed to identify, evaluate, and synthesize the best available evidence for the prevention and management of postoperative tracheostomy complications in patients with laryngeal cancer. Methods The evidence-based question was structured using the PIPOST framework. Systematic searches were conducted up to February 22, 2026, across multiple databases and resources, including BMJ Best Practice, UpToDate, the International Guideline Library, Cochrane Library, PubMed, China National Knowledge Infrastructure (CNKI), and Wanfang Data. The search targeted various evidence types such as clinical decisions, guidelines, expert consensuses, evidence summaries, systematic reviews, and randomized controlled trials (RCTs). Literature screening, quality assessment, data extraction, and evidence synthesis were performed independently by two researchers, integrating professional judgment. Results A total of 24 publications were included, comprising 5 guidelines, 8 evidence summaries, 6 expert consensus papers, 2 clinical decisions, 1 systematic review, and 2 RCTs. From these, 48 best practice recommendations were summarized and categorized into five key themes: multidisciplinary team and systematic management, artificial airway maintenance and safety, prevention and management of complications, active rehabilitation and dysphagia management, and nutritional support and prevention of malnutrition. Discussion This work provides a comprehensive and practical summary of the best current evidence. Healthcare professionals are recommended to apply these findings in clinical practice, tailored to specific contexts and patient preferences, in order to develop systematized, proactive, and function-oriented care protocols, which are crucial for reducing complication rates and improving patient outcomes. Systematic Review Registration http://ebn.nursing.fudan.edu.cn/home , identifier ES20258917.