Early oral feeding and its impact on postoperative outcomes in head and neck cancer surgery: a meta-analysis.

IF 2 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Maxillofacial Plastic and Reconstructive Surgery Pub Date : 2024-03-28 DOI:10.1186/s40902-024-00421-0
Yomna E Dean, Karam R Motawea, Bdoor Ahmed A Bamousa, Jose J Loayza Pintado, Sameh Samir Elawady, Mohammed Soffar, Jaffer Shah, Kailyn Wilcox, Hani Aiash
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Abstract

Background: Early oral feeding has been previously postulated to contribute to developing postoperative complications following head and neck reconstructive surgeries using free flaps. This study assessed the association between the timing of oral feeding (early vs. late) and postoperative complications and length of hospital stay among these patients.

Method: PubMed, Scopus, Cochrane, and Web of Science were searched using terms such as "oral feeding" and "head or neck cancer." We utilized RevMan software version 5.4 for the analysis. The study defined early oral feeding as feeding within 5-day post-operation, while late oral feeding was defined as feeding after the fifth postoperative day. Five papers that met the inclusion criteria were included in the analysis, with 1097 patients.

Results: The results showed that early feeding was not significantly associated with postoperative fistulas (RR 0.49, 95% CI 0.23 to 1.05, p-value = 0.07), hematoma/seroma (RR 0.71, 95% CI 0.33 to 1.51, p-value = 0.38), or flap failure (RR 0.84, 95% CI = 0.38 to 1.87, p-value = 0.67). However, early oral feeding was significantly associated with shorter hospital stays than late oral feeding (MD -3.18, 95% CI -4.90 to -1.46, p-value = 0.0003).

Conclusion: No significant difference exists between early and late oral feeding regarding the risk of postoperative complications in head and neck cancer (HNC) patients who underwent free flap reconstruction surgery. However, early oral feeding is significantly associated with a shorter hospital stay than late oral feeding. Thus, surgeons should consider implementing early oral feeding after free flap reconstruction in HNC patients.

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早期口服喂养及其对头颈部癌症手术术后效果的影响:一项荟萃分析。
背景:以前曾有人推测,过早进行口腔喂养会导致使用游离皮瓣进行头颈部整形手术后出现术后并发症。本研究评估了口腔喂养时间(早期与晚期)与这些患者术后并发症和住院时间之间的关系:方法:使用 "口腔喂养 "和 "头颈部癌症 "等术语对 PubMed、Scopus、Cochrane 和 Web of Science 进行了检索。我们使用 RevMan 软件 5.4 版进行分析。研究将早期口腔喂养定义为术后 5 天内的喂养,而晚期口腔喂养则定义为术后第 5 天后的喂养。符合纳入标准的 5 篇论文被纳入分析,共纳入 1097 名患者:结果显示,早期喂养与术后瘘管(RR 0.49,95% CI 0.23 至 1.05,P 值 = 0.07)、血肿/血槽瘤(RR 0.71,95% CI 0.33 至 1.51,P 值 = 0.38)或皮瓣失败(RR 0.84,95% CI = 0.38 至 1.87,P 值 = 0.67)无显著相关性。然而,与晚期口服喂养相比,早期口服喂养明显缩短了住院时间(MD -3.18,95% CI -4.90至-1.46,P值 = 0.0003):在接受游离皮瓣重建手术的头颈癌(HNC)患者中,早期和晚期口服喂养在术后并发症风险方面没有明显差异。不过,与晚期口服喂养相比,早期口服喂养明显缩短了住院时间。因此,外科医生应考虑在 HNC 患者接受游离皮瓣重建手术后尽早进行口腔喂养。
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来源期刊
Maxillofacial Plastic and Reconstructive Surgery
Maxillofacial Plastic and Reconstructive Surgery DENTISTRY, ORAL SURGERY & MEDICINE-
CiteScore
4.30
自引率
13.00%
发文量
37
审稿时长
13 weeks
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