Evaluating Effective Feeding Methods for Nutritional Management in Head and Neck Cancer Patients Post-Surgery: A...

This systematic review evaluates the effectiveness of feeding interventions-early oral feeding, nasogastric tube feeding, and gastrostomy tube feeding-in supporting postoperative recovery in head and neck cancer patients. The primary objective is to identify the most effective feeding strategy based on outcomes such as wound dehiscence, infections, aspiration, pharyngo-cutaneous fistula, flap necrosis, and length of hospital stay.

Studies were selected based on specific inclusion criteria, focusing on head and neck cancer patients receiving alternate feeding methods post-surgery. Databases searched included PubMed, CINAHL, Embase, Cochrane, Web of Science, and Scopus, with the last search conducted on April 10, 2023. Risk of bias was assessed using the Cochrane Risk of Bias tools (RoB-2 for randomized studies and ROBINS-I for non-randomized studies). Data were synthesized and results presented in structured tables, comparing clinical outcomes across feeding methods.

Ten studies involving 623 participants met the inclusion criteria. Early oral feeding was associated with reduced hospital stay and comparable or lower rates of complications, such as wound dehiscence and infections, relative to nasogastric and gastrostomy feeding. Among studies comparing early oral and nasogastric feeding, early oral feeding showed a potential advantage in recovery time, although gastrostomy feeding presented mixed outcomes with occasional higher infection rates.

This review highlights the benefits of early oral feeding in enhancing recovery and minimizing complications. Limitations include heterogeneity in study designs, small sample sizes, and variability in outcome definitions, which may affect the robustness of these findings.