口腔游离皮瓣重建术后的早期喂养：一项系统评价与荟萃分析。
Early feeding after free flap reconstruction of the oral cavity: A systematic review and meta-analysis.
作者信息
Barlow Joshua, Sragi Zara, Rodriguez Nina, Alsen Mathilda, Kappauf Catharine, Ferrandino Rocco, Chennareddy Susmita, Kotz Tamar, Kirke Diana N, Teng Marita S, Genden Eric M, Khan Mohemmed N, Roof Scott A
机构信息
Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
出版信息
Head Neck. 2024 May;46(5):1224-1233. doi: 10.1002/hed.27684. Epub 2024 Feb 27.
BACKGROUND
Traditionally, patients undergoing free flap reconstruction for oral cavity defects have been given nothing by mouth for 6-14 days post-operatively due to concern for orocutaneous fistula development.
METHODS
Multiple databases were screened for studies assessing the rate of orocutaneous fistula formation in early (≤5 days) versus late (>5 days) feeding groups following oral cavity free flap reconstruction. Fixed- and random-effects meta-analyses were used.
RESULTS
One randomized controlled trial, one prospective cohort, and three retrospective cohort studies were included. The early feeding group displayed no significant increase in orocutaneous fistula formation (RD = -0.02, p = 0.06) or free flap failure (RD = -0.01, p = 0.39), with a significantly shorter hospital length of stay (mean difference [days] = -2.43, p < 0.01).
CONCLUSIONS
While further prospective trials are necessary, initiation of oral intake before post-operative day 5 may be appropriate in properly selected patients following oral reconstruction.
背景
传统上，由于担心发生口腔皮肤瘘，接受口腔缺损游离皮瓣重建的患者术后6 - 14天一直禁食。
方法
对多个数据库进行筛选，以寻找评估口腔游离皮瓣重建术后早期（≤5天）与晚期（>5天）进食组口腔皮肤瘘形成率的研究。采用固定效应和随机效应荟萃分析。
结果
纳入一项随机对照试验、一项前瞻性队列研究和三项回顾性队列研究。早期进食组口腔皮肤瘘形成（RD = -0.02，p = 0.06）或游离皮瓣失败（RD = -0.01，p = 0.39）无显著增加，住院时间显著缩短（平均差异[天]= -2.43，p < 0.01）。
结论
虽然需要进一步的前瞻性试验，但对于经过适当选择的口腔重建术后患者，术后第5天之前开始经口进食可能是合适的。
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