Anakapu Kimberley, Wilson Michael, Findlay Merran, Brown Teresa, Bauer Judith
School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Queensland, Australia.
Nutrition and Dietetics, Royal Brisbane & Women's Hospital, Brisbane, Queensland, Australia.
Head Neck. 2022 Jan;44(1):238-253. doi: 10.1002/hed.26913. Epub 2021 Nov 1.
This systematic review examined nutritional outcomes in patients undergoing transoral robotic surgery (TORS), compared to open surgery (OS) for head and neck cancer. PUBMED, CINAHL, and Web of Science were systematically reviewed. Target nutritional outcomes included: weight, nutritional status, use of enteral feeding, swallowing function/ability, and time to oral diet. Risk of bias was assessed using the risk of bias in non-randomized studies tool, and certainty of evidence was assessed using grading of recommendations, assessment, development, and evaluation (GRADE). Eight studies were included (total n = 608). Compared to OS, TORS probably reduces short- and long-term enteral feeding use or duration (GRADE "moderate" certainty), may reduce time to full swallow ability (GRADE "low" certainty), but it remains uncertain whether TORS reduces long-term patient reported swallowing function or time to oral feeding (GRADE "very-low" certainty). No studies examined nutritional status or weight. There is limited body of evidence examining nutrition outcomes following TORS. Further studies are warranted, which may improve the certainty of evidence and assist in determining the optimal nutrition care for these patients.
本系统评价比较了经口机器人手术（TORS）与开放手术（OS）治疗头颈癌患者的营养结局。对PUBMED、CINAHL和科学网进行了系统检索。目标营养结局包括：体重、营养状况、肠内营养使用情况、吞咽功能/能力以及恢复经口饮食的时间。使用非随机研究中的偏倚风险工具评估偏倚风险，并使用推荐分级、评估、制定与评价（GRADE）方法评估证据的确定性。纳入了8项研究（共608例）。与开放手术相比，经口机器人手术可能会减少短期和长期肠内营养的使用或持续时间（GRADE“中等”确定性），可能会缩短完全恢复吞咽能力的时间（GRADE“低”确定性），但经口机器人手术是否能改善长期患者报告的吞咽功能或缩短恢复经口进食的时间仍不确定（GRADE“极低”确定性）。没有研究考察营养状况或体重。关于经口机器人手术后营养结局的证据有限。有必要开展进一步研究，这可能会提高证据的确定性，并有助于确定这些患者的最佳营养护理方案。
