Jaxa-Kwiatkowski Andrzej, Jaxa-Kwiatkowski Marek, Jaxa-Kwiatkowska Katarzyna, Gerber Hanna, Kubiak Marcin, Łysenko Lidia
Clinical Department of Maxillofacial Surgery, Faculty of Dentistry, Wroclaw Medical University, 50-367 Wrocław, Poland.
Department of Maxillofacial Surgery, Heliodor Swiecicki Clinical Hospital in Poznan, 60-355 Poznan, Poland.
J Clin Med. 2025 May 23;14(11):3679. doi: 10.3390/jcm14113679.
Head and neck cancer (HNC) remains a major global health issue. It is closely linked to smoking, alcohol use, and HPV infection. Nutritional and metabolic factors significantly influence surgical outcomes in these patients, especially when undergoing extensive resections and microsurgical free flap reconstruction. This comprehensive review aims to evaluate how perioperative nutritional status-particularly body mass index (BMI), serum albumin and prealbumin levels, and enteral vs. oral feeding strategies-affects complication rates, wound healing, surgical duration, and overall recovery. Poor nutritional status is associated with increased complication rates, prolonged surgery, impaired wound healing, and higher perioperative mortality. Both high and low BMI negatively impact surgical outcomes. Obesity is linked to protracted surgery and increased blood loss, while underweight patients have higher perioperative mortality. Optimizing perioperative nutrition is important for improving surgical outcomes in HNC patients. A multidisciplinary approach is necessary to tailor nutritional support and enhance recovery. Further research should focus on long-term weight management strategies and identifying biomarkers predictive of surgical success.
头颈癌（HNC）仍然是一个重大的全球健康问题。它与吸烟、饮酒和人乳头瘤病毒（HPV）感染密切相关。营养和代谢因素显著影响这些患者的手术结果，尤其是在进行广泛切除和显微外科游离皮瓣重建时。这篇综述旨在评估围手术期营养状况——特别是体重指数（BMI）、血清白蛋白和前白蛋白水平以及肠内与口服喂养策略——如何影响并发症发生率、伤口愈合、手术时长和整体恢复情况。营养状况不佳与并发症发生率增加、手术时间延长、伤口愈合受损以及围手术期死亡率升高有关。高BMI和低BMI都会对手术结果产生负面影响。肥胖与手术时间延长和失血增加有关，而体重过轻的患者围手术期死亡率更高。优化围手术期营养对于改善头颈癌患者的手术结果很重要。需要采用多学科方法来定制营养支持并促进恢复。进一步的研究应侧重于长期体重管理策略，并确定预测手术成功的生物标志物。
