2019 Volume 1 Issue 3 Pages 140-148
Objective: Dysphagia often occurs after surgical resection of locally advanced head and neck cancer. Hence, an appropriate tube feeding formula must be selected for safe swallowing rehabilitation. Our hospital developed and introduced a new dysphagia diet in accordance with the Japanese Dysphagia Diet 2013 developed by the Dysphagia Diet Committee of the Japanese Society Dysphagia Rehabilitation. This study examined the effectiveness and safety of our new dysphagia diet.
Methods: In total, 99 patients with oral cancer who underwent resection and reconstruction from August 2012 to July 2016 were included; 47 patients used the conventional dysphagia diet (conventional group) and 52 used the new dysphagia diet (new group). The postoperative courses of the two groups were compared, including the period from the start of oral intake to removal of the nasogastric tube, the period from the start of oral intake to discharge, and the incidence of aspiration pneumonia.
Results: The median period from the start of oral intake to discharge was significantly shorter in the new group at 16.0 (12.3-25.0) days than in the conventional group at 22.0 (16.0-32.8) days (p = 0.002). In addition, the incidence of aspiration pneumonia tended to be lower in the new group (3.9%) than in the conventional group (10.6%; p = 0.19). In the subgroup of patients with aspiration pneumonia, the median period from the start of oral intake to removal of the nasogastric tube tended to be shorter in the new group (10.5 days) than in the conventional group (19.0 days; p = 0.43).
Conclusion: Our new dysphagia diet was introduced safely without increasing the incidence of aspiration pneumonia. The new diet offers an appropriate tube feeding formula for individual oral cancer patients according to the degree of dysphagia after surgery, and thus is expected to facilitate effective and safe swallowing rehabilitation.
