The effect of nutrition intervention on gastrointestinal complications after head and neck cancer surgery

BACKGROUND/OBJECTIVES: Malnutrition is associated with postoperative complications and delayed recovery in patients with head and neck cancer (HNC). This study investigated the effect of fiber-containing low-fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (low-FODMAP) formula on the incidence of gastrointestinal (GI) complications with tube feeding after HNC surgery. SUBJECTS/METHODS: This retrospective study included 152 tube-fed patients who received nutritional support team care after undergoing surgery for HNC. The differences in nutritional status, nutrition supply, and length of hospital stay were compared according to tube feeding-associated GI complications. The receiver operating characteristic (ROC) curve was generated between Prognostic Nutritional Index, Nutritional Risk Index, a Nutrition Risk Screening 2002 (NRS-2002), and Global Leadership Initiative on Malnutrition (GLIM) as the reference standard. The correlation between changes in the fiber-containing low-FODMAP formula and diarrhea incidence during tube feeding was evaluated. RESULTS: Of 152 patients, 49.3% (n = 75) experienced GI complications during tube feeding. Patients with GI complications were hospitalized for approximately 10 days longer than those without complications. The prevalence rate of GLIM-defined malnutrition was 37.5% at admission. The percentage of patients at risk of developing malnutrition with NRS-2002 score ≥ 3 was 28.3% at admission. The area under the ROC curve of the NRS-2002 score for the GLIM diagnostic criteria for malnutrition was 0.908. The fiber-containing low-FODMAP formula change reduced the stool frequency in patients with diarrhea. CONCLUSION: Our study findings provide essential data for establishing guidelines for selecting suitable formulas for tube-fed patients who have previously experienced diarrhea after HNC surgery.