Faculty Collaboration Database

Nasogastric tube feeding after transoral robotic surgery for oropharynx carcinoma. Am J Otolaryngol 2021;42(3):102857

Date

01/30/2021

Pubmed ID

33513477

DOI

10.1016/j.amjoto.2020.102857

Scopus ID

2-s2.0-85099858579 (requires institutional sign-in at Scopus site)   5 Citations

Abstract

PURPOSE: 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).

MATERIALS AND METHODS: 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.

RESULTS: 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.

CONCLUSIONS: 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.

Author List

Plonowska KA, Ochoa E, Zebolsky AL, Patel N, Hoppe KR, Ha PK, Heaton CM, Ryan WR

Author

Kathryn Hoppe MD Staff Physician in the Otolaryngology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Aged, 80 and over
Carcinoma, Squamous Cell
Enteral Nutrition
Female
Humans
Intubation, Gastrointestinal
Male
Middle Aged
Oral Surgical Procedures
Oropharyngeal Neoplasms
Retrospective Studies
Risk Factors
Robotic Surgical Procedures
Time Factors
Tongue
Tonsillectomy