Feeding in Oral Cancer Patients After Massive Ablative Surgery

Abstract

Feeding after ablative oral cancer surgery is a major concern in postoperative care phase. The aim of this study was to compare postoperative phase of healing in patients undergoing nasogastric tube insertion and percutaneous endoscopic gastrostomy. In this single randomized clinical trial, 40 patients were randomly allocated to 2 groups according to a randomized list: group one (20 patients) had nasogastric tube for 4 weeks and group two (20 patients) underwent percutaneous endoscopic gastrostomy for 4 weeks or more after the surgery. Occurrence of infection and wound dehiscence was assessed. Weight loss was defined as reduction in patients' weight at 4 weeks after the surgery compared with preoperation. Weight loss was 7.9 ± 1.91 kg in group one and 5.3 ± 1.38 kg in group two; the difference in this regard between the 2 groups was statistically significant (P = 0.001). In group one, 10 subjects had dehiscence versus 3 subjects in group two; this difference was significant (P = 0.04). Analysis of the data demonstrated a significant difference in postsurgical infection between the 2 groups (P = 0.044). It seems that gastrostomy may be an appropriate method for feeding in patients with extensive oral cancer.

Effect of Prophylactic Placement of Percutaneous Endoscopic Gastrostomy on the Surgical Prognosis in Patients With Oral Cancer: A Pilot Study

“…Meanwhile, pPEG also facilitates postoperative oral hygiene and accordingly ameliorates wound dehiscence. 6…”

“…We believe that the nutritional approach of pPEG, unlike oral or nasogastric feeding, minimizes bacterial colonization, which is beneficial for the reestablishment of the oral mucosal barrier, thereby reducing the occurrence of SSI. Meanwhile, pPEG also facilitates postoperative oral hygiene and accordingly ameliorates wound dehiscence 6 …”

S3-Leitlinie Heimenterale und heimparenterale Ernährung der Deutschen Gesellschaft für Ernährungsmedizin (DGEM)

“…Weitere frühere systematische Übersichten ergänzen die Empfeh-lung [193,[195][196][197][198] und zeigen, dass bei PEG/PEJ das Risiko einer Verlagerung der Sonde geringer ist [197,198]. In einer RCT bei Mundkrebs-Patienten zeigte sich ein signifikanter Nutzen der PEG bei postoperativen Wundinfektionen im Vergleich zur Nasensonde [199]. Eine weitere systematische Überprüfung konnte keine eindeutigen Schlussfolgerungen darüber ziehen, ob die PEG-gegenüber Sondenernährung bei älteren Nicht-Schlaganfall-Dysphagie-Patienten von Vorteil war [200].…”