McAuley D, Barry T, McConnell K, Smith J, Stenhouse J
Department of Oral and Maxillofacial Surgery, Altnagelvin Area Hospital, United Kingdom.
Department of Oral and Maxillofacial Surgery, Altnagelvin Area Hospital, United Kingdom.
Br J Oral Maxillofac Surg. 2015 Sep;53(7):618-20. doi: 10.1016/j.bjoms.2015.03.018. Epub 2015 Apr 22.
Traditionally, after resection of oral cancer and free flap reconstruction, patients are given nothing by mouth for between 6 and 12 days to allow adequate time for healing and to reduce the risk of dehiscence. To assess the impact of early oral feeding after operation we retrospectively reviewed 10 consecutive patients who had had surgical resection and free flap reconstruction for oral cancer. Details recorded included histopathological findings, stage and site of the primary tumour, and type of reconstruction. Data on the duration of tracheostomy, commencement of clear fluids and diet, complications, and duration of hospital stay, were also recorded. Half of the patients were able to tolerate clear fluids orally by the first postoperatively day and the remaining half by the second. By the fourth day, 8 could manage a pureed diet. There were no complications. A mean duration of hospital stay of 11 days (range 5-16) compared favourably with previous studies. Early oral feeding was not associated with any increased morbidity or adverse outcome. A shorter hospital stay may favour the adoption of an improved recovery programme as seen in other surgical specialties.
传统上,口腔癌切除及游离皮瓣重建术后,患者需禁食6至12天,以便有足够时间愈合,并降低裂开风险。为评估术后早期经口进食的影响,我们回顾性分析了10例连续接受口腔癌手术切除及游离皮瓣重建的患者。记录的详细信息包括组织病理学结果、原发肿瘤的分期和部位以及重建类型。还记录了气管切开的持续时间、开始进食清流食和饮食的时间、并发症以及住院时间。一半患者术后第一天就能经口耐受清流食,另一半在第二天能耐受。到第四天时,8例患者可以进食泥状食物。未出现并发症。平均住院时间为11天(范围5 - 16天),与之前的研究相比情况良好。早期经口进食未导致任何发病率增加或不良后果。较短的住院时间可能有利于采用其他外科专科中可见的改进康复方案。