Liječenje malignih tumora usne šupljine i orofarinksa uzrokuje ozbiljne mutilacije, koje zbog funkcionalnog značaja ovih anatomskih područja, ugrožavaju vitalno važne funkcije: disanje, gutanje, žvakanje i govor. Radioterapija i kemoterapija predstavljaju uobičajenu dopunu kirurškom liječenju, a njihove posljedice – radiomukozitis, edem, dehidracija, te postradijacijska fibroza, uzrokuju još izraženije disfagične teškoće. Disfagija može biti životno ugrožavajući simptom kod bolesnika s orofaringealnim
karcinomom jer onemogućava uzimanje dovoljnih količina hrane na usta, a povećava i rizik od aspiracije.
Posljedica je malnutricija bolesnika, porast morbiditeta, sporije i otežano cijeljenje rana, te viši mortalitet.
Enteralna nutricija, s kojom ovisno o općem stanju bolesnika i očekivanoj duljini liječenja, treba započeti što ranije, najprihvatljiviji je način dugotrajnog hranjenja i dohranjivanja. Kada disfagične smetnje traju dulje od 6 tjedana, koliko je rutinski prihvatljiva nazogastrična sonda (NGS), najbolje je hranjenje izravno putem cijevi u želudac – gastrostoma. Postoji više metoda, a danas je široko u primjeni perkutana endoskopska gastrostoma – PEG. To je tehnički relativno jednostavna i brza metoda, koja ne zahtijeva opću
anesteziju, čime se izbjegavaju često otežane intubacije, a za bolesnike je prihvatljiva po udobnosti i manjoj mogućnosti komplikacija.Treatment of malignant tumours of the oral cavity and oropharynx causes severe mutilations, which, due to the functional significance of these anatomical areas, endanger vitally important functions: breathing, swallowing, chewing and speech. Radiotherapy and chemotherapy are the usual complements to surgical treatment, and their consequences; radiomucositis, edema, dehydration, post-radiation fibrosis, cause even more pronounced dysphagical difficulties. Dysphagia can be a life-threatening symptom in patients with oropharyngeal cancer because it prevents taking enough food by mouth, and increases the risk of aspiration. The result is patients\u27 malnutrition, increased morbidity, slower and more difficult wound healing and higher mortality.
Enteral nutrition, which, depending on the general condition of the patient and the expected length of treatment, should be started as early as possible, and it is the most acceptable way of long-term feeding.
When dysphagic disturbances last longer than 6 weeks, feeding directly into the stomach is the most acceptable manner, so, if possible, a nasogastric tube is inserted. There are several methods, and today the most widespread is the use of percutaneous endoscopic gastrostomy – PEG. It is a technically relatively
simple and fast method that requires no general anesthesia which avoids the often difficult intubation. That method is also convenient for patients due to being comfortable and of low complication possibility
