Summary
Background
Supplementary nutrition is an important aspect of the multidisciplinary management
of head and neck cancer patients. In our unit, method of feeding is based on an arbitrary
predicted duration of overall treatment (<30 days indicates NG feeding, >30 days prophylactic
PEG tube insertion is appropriate). This paper provides a guideline to assist in choosing
the feeding method early on to avoid the need for later PEG insertion in those who
were initially fed orally or via NG tube.
Patients and methods
59 patients undergoing resection of head and neck tumours were included, grouped according
to their tumour stage and location. They were assessed pre- and post-operatively for
5 years and their diet consistency score, method of supplementary feeding and weight
were noted.
Results
Mean prophylactic PEG feeding duration was 771 days (N = 12), these patients mostly
had T3/T4 tumours involving the tongue. Mean NG duration was 30.5 days (N = 42), 15
later had PEG insertion at mean 47 days post-operatively, resulting in a total mean
supplementary feeding duration of 579.6 days. These patients tended to have higher
stage tumours and poorer pre-operative diet consistency scores. 43 patients required
post-operative radiotherapy. This significantly increased feeding duration versus
surgery alone, and therefore increases the likelihood of requiring PEG insertion.
Conclusions
Based on our findings, we have constructed an algorithm to assist in determining which
patients with operable head and neck cancer should have prophylactic PEG tube insertion.
Keywords
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Article info
Publication history
Published online: December 02, 2011
Accepted:
November 8,
2011
Received:
August 22,
2011
Identification
Copyright
© 2011 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Inc. All rights reserved.
