Otolaryngology, Head and Neck Surgery
OBJECTIVES: Squamous cell carcinoma of the oral cavity has a profound impact on a patient's nutritional intake, 40-50% of head and neck cancer patients have a markedly impaired nutritional status at the time of their initial presentation. Studies show that patients who have better nutritional status have fewer complications and a better survival rate. Therefore, enteral nutritional support plays an important part in their management. Due to the lack of relevant data, surgeons help patients make informed decisions regarding their mode of nutritional support and perform gastrostomy or place nasogastric tube depending on the patient's preference. This study addresses the need for scientific data regarding the impact and psychosocial acceptance of both these modalities in our population.
METHODS: A retrospective review of patient's charts with a principle diagnosis of squamous cell carcinoma of the oral cavity, receiving surgery +/- adjuvant radiotherapy was carried out. Patients were also questioned regarding their experience with the mode of nutrition and its impact on their life during their regular follow up consultations. Post therapy change in weight, psychosocial acceptance and quality of life were considered as measures of outcome.
RESULTS: A mean weight loss of 5.43 +/- 3.4 kg (p = 0.025) was noticed in 15 patients on nasogastric feeding. On the other hand, significantly less weight loss of 1.25 +/- 5.12 kg (p = 0.025) was noticed in the patients receiving nutrition via gastrostomy tubes; nine patients had a mean weight gain of 2.89 +/- 1.95 kg and the rest had similar weight loss of 5.427 +/- 3.4 kg.
CONCLUSION: The authors of the study recommend that gastrostomies should be considered for patients requiring long term post operative enteral nutritional support in patients of head and neck cancers.
Journal of the Pakistan Medical Association
(2011). Comparison of outcomes of enteral feeding via nasogastric versus gastrostomy tubes in post operative patients with a principle diagnosis of squamous cell carcinoma of the oral cavity. Journal of the Pakistan Medical Association, 61(10), 1042-5.
Available at: http://ecommons.aku.edu/pakistan_fhs_mc_surg_otolaryngol_head_neck/12