Background: In head and neck surgery artificial enteral tube feeding is of great importance. Excluding the operation area from direct contact with food helps proper healing of the surgical wound. For these purposes nasogastric (NG) or percutaneous endoscopic gastrostomy (PEG) tubes might be used. Depending of localisation of the tumour different types of surgery are done. Nowadays PEG is widespread and NG tube is perhaps unfairly forgotten. Materials and methods: We examined 96 NG and 75 PEG tube fed patients who were operated for head and neck cancer (HNC). Based on type of surgery we divided our patients in four groups. Group I (n1=57 pts, NG/PEG=28/29) included patients with partial laryngeal and/or partial pharyngeal resection with local reconstruction. Group II patients (n2=32, NG/PEG=25/7) with total laryngeal resection and partial pharyngeal resection with local reconstruction. Group III patients (n3=32, NG/PEG=13/19) who required flap reconstruction after total laryngectomy and partial pharyngectomy. Group IV patients (n4=50, NG/PEG=30/20) with oral cavity or mesopharyngeal tumour, whose operation in addition to tumour resection involved also mandible resection and flap reconstruction. We investigated complications, the beginning of per os nutrition, the learning of swallowing and the length of the recovery period.
Results:
Group I Group II Group III Group IV
NG PEG NG PEG NG PEG NG PEG
Per os
feeding (days) 25 20* 14 20 29 22* 20 20
Decanulation 36 24*
Emission (days) 39 31* 16 28 34 28* 28 30
Major complic. 8 6 1 1 2 3 5 5
Minor complic. 3 4 4 0 7 5 8 4
* significant difference
Conclusions: PEG is significantly more advantageous than NG tube feeding for patients with supraglottic laryngeal resection, hemipharyngolaryngectomy or total laryngeal and partial pharyngeal resection with flap reconstruction (group I and III). Because of the long recovery time for group IV patients (oral cavity or mesopharynx tumour surgery with mandible resection and flap reconstruction) PEG is recommended.
