Department of Otolaryngology - Head and Neck Surgery, University of California - San Francisco, 2380 Sutter Street, Third Floor, San Francisco, CA 98115, United States of America.
University of California - San Francisco School of Medicine, 533 Parnassus Avenue, San Francisco, CA 94143, United States of America.
Am J Otolaryngol. 2021 May-Jun;42(3):102857. doi: 10.1016/j.amjoto.2020.102857. Epub 2021 Jan 22.
To determine the need for and predictors of nasogastric tube feeding (NGTF) use and duration after transoral robotic surgery (TORS) for oropharynx squamous cell carcinoma (OPSCC).
This is a retrospective cohort study. For 95 OPSCC patients undergoing TORS with or without concurrent unilateral or bilateral neck dissections (ND), we evaluated NGTF use and duration, along with demographic, clinical, histopathologic, and treatment risk factors.
23.2% (22/95) of patients received NGTF. Univariate analysis found that NGTF was significantly more likely in larger tumor specimens (mean: 2.32 cm vs. 1.84 cm; p = 0.043) and after concurrent bilateral (46.7%) compared to unilateral (17.4%) ND (p = 0.043). Multivariable analysis also found increased tumor size (p = 0.035) and concurrent bilateral ND (p = 0.04) to be significant risk factors for NGTF. The following were not statistically significantly associated with NGTF use: sex, age, smoking history, HPV status, base of tongue (BOT) resection (20%) vs. radical tonsillectomy (25.9%), pT2 (27.0%) vs. pT1 (20.4%) vs pT0 (16.7%), BOT with (28.6%) vs. without epiglottis resection (22.2%), and surgery for additional margins the same day (27.3%) (all p > 0.1). Patients who underwent NGTF had a mean duration of 18 days (2-96, SD: 20.7 days) with 12 (55.6%) having over 2 weeks of use. No significant predictors of longer duration of NGTF were identified.
A majority of patients undergoing TORS do not need NGTF. When NGTF is needed, the duration of use is usually longer than 14 days. Larger tumor size and concurrent bilateral ND are risk factors for NGTF.
确定经口机器人手术（TORS）治疗口咽鳞状细胞癌（OPSCC）后使用鼻胃管（NGTF）的必要性和预测因素，以及使用时间。
这是一项回顾性队列研究。对 95 例接受 TORS 治疗的 OPSCC 患者（包括或不包括单侧或双侧颈部清扫术（ND）），评估了 NGTF 的使用情况和时间，以及人口统计学、临床、组织病理学和治疗风险因素。
23.2%（22/95）的患者需要使用 NGTF。单因素分析发现，肿瘤标本较大（平均：2.32cm 与 1.84cm；p=0.043）和双侧（46.7%）相比单侧（17.4%）ND（p=0.043）时，更有可能使用 NGTF。多因素分析还发现肿瘤大小增大（p=0.035）和双侧 ND（p=0.04）是使用 NGTF 的显著危险因素。以下因素与使用 NGTF 无统计学相关性：性别、年龄、吸烟史、HPV 状态、舌根（BOT）切除（20%）与根治性扁桃体切除术（25.9%）、pT2（27.0%）与 pT1（20.4%）与 pT0（16.7%）、BOT 伴（28.6%）与无会厌切除术（22.2%）、以及同日进行额外切缘手术（27.3%）（所有 p>0.1）。接受 NGTF 的患者平均使用时间为 18 天（2-96，标准差：20.7 天），12 例（55.6%）使用时间超过 2 周。没有发现 NGTF 使用时间较长的显著预测因素。
大多数接受 TORS 治疗的患者不需要使用 NGTF。当需要使用 NGTF 时，使用时间通常超过 14 天。较大的肿瘤大小和双侧 ND 是 NGTF 的危险因素。
