Association of perioperative oral swallowing function with post-esophagectomy outcomes and nutritional statuses in patients with esophageal cancer.

S. Matsumoto, K. Wakatsuki, Hiroshi Nakade, T. Kunishige, Shintaro Miyao, Satoko Aoki, Akinori Tsujimoto, Takanari Tatsumi, Masahiro Soga, Masayuki Sho
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Abstract

Dysphagia after esophagectomy is a serious complication; however, no method has been established to accurately assess swallowing function. We evaluated the association of swallowing function tests with patients' post-esophagectomy complications and nutritional statuses. We retrospectively reviewed the data of 95 patients with esophageal cancer who underwent esophagectomy between 2016 and 2021. We performed perioperative swallowing function tests, including the repetitive saliva swallowing test (RSST), maximum phonation time (MPT), and laryngeal elevation (LE). Patients with recurrent laryngeal nerve palsy (RLNP) and respiratory complications (RC) had significantly lower postoperative RSST scores than patients without them; the scores in patients with or without anastomotic leakage (AL) were similar. Postoperative MPT in patients with RLNP was shorter than that in patients without RLNP; however, it was similar to that in patients with or without AL and RC. LE was not associated with any complications. Patients with an RSST score ≤2 at 2 weeks post-esophagectomy had significant weight loss at 1, 6, and 12 months postoperatively compared with patients with an RSST score ≥3. The proportion of patients with severe weight loss (≥20% weight loss) within 1 year of esophagectomy was significantly greater in patients with RSST scores ≤2 than in those with RSST scores ≥3. Multivariate analysis showed that an RSST score ≤2 was the only predictor of severe post-esophagectomy weight loss. RSST scoring is a simple tool for evaluating post-esophagectomy swallowing function. A lower RSST score is associated with postoperative RLNP, RC, and poor nutritional status.
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食管癌患者围手术期口腔吞咽功能与食管切除术后疗效和营养状况的关系。
食管切除术后吞咽困难是一种严重的并发症,但目前还没有一种方法能准确评估吞咽功能。我们评估了吞咽功能测试与患者食管切除术后并发症和营养状况的关系。我们回顾性审查了2016年至2021年间接受食管切除术的95名食管癌患者的数据。我们进行了围手术期吞咽功能测试,包括重复唾液吞咽试验(RSST)、最大发音时间(MPT)和喉头抬高(LE)。有喉返神经麻痹(RLNP)和呼吸系统并发症(RC)的患者术后RSST评分明显低于没有这些并发症的患者;有或没有吻合口漏(AL)的患者评分相似。有 RLNP 的患者术后 MPT 比没有 RLNP 的患者短,但与有或没有 AL 和 RC 的患者相似。LE与任何并发症无关。与 RSST 评分≥3 的患者相比,食管切除术后 2 周时 RSST 评分≤2 的患者在术后 1、6 和 12 个月时体重明显下降。食管切除术后 1 年内体重严重下降(体重下降≥20%)的患者比例在 RSST 评分≤2 的患者中明显高于 RSST 评分≥3 的患者。多变量分析显示,RSST 评分≤2 是预测食管切除术后体重严重下降的唯一指标。RSST 评分是评估食管切除术后吞咽功能的简单工具。RSST 评分越低,术后 RLNP、RC 和营养状况越差。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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