Document Detail


Endoscopic classification for reflux pharyngolaryngitis.
MedLine Citation:
PMID:  19549209     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The quality of life in patients who have undergone surgery for esophageal cancer is frequently disturbed by postoperative gastroesophageal reflux disease or pharyngolaryngeal reflux disease. Recently, there have been many reports on gastroesophageal reflux disease after esophagectomy, and only a few on pharyngolaryngeal reflux disease. There is not yet any convenient endoscopic classification of reflux pharyngolaryngitis. We designed a new classification for reflux pharyngolaryngitis based on endoscopic findings. Our new classification consists of the five grades from 0 to IV based on (i) the extent and severity of erythema and/or edema in the pharynx and the larynx, and (ii) the extent and severity of granulation or scarring stenosis in the vocal cords. Ninety-three patients after cervical esophagogastrostomy after esophagectomy (the CEG group) and 28 patients after intrathoracic esophagogastrostomy (the TEG group) were reviewed in this study. We investigated the relation between the severity of reflux pharyngolaryngitis and clinical symptoms in these patients, and the correlation between this new classification of reflux pharyngolaryngitis and the Los Angeles classification of reflux esophagitis. Reflux esophagitis was more severe in the TEG group than in the CEG group, while there was no difference in the grading of reflux pharyngolaryngitis between the two groups. The pharyngolaryngeal symptoms and F-scale scores were not correlated with the severity of reflux pharyngolaryngitis in each group. The grading of reflux pharyngolaryngitis and that of reflux esophagitis was correlated in each group (P<0.001 in the CEG group and P=0.002 in the TEG group). We proposed a new endoscopic classification of reflux pharyngolaryngitis. The new classification of reflux pharyngolaryngitis correlated fairly well with the Los Angeles classification of reflux esophagitis, although this classification did not correlate with the clinical symptoms in patients who underwent esophagectomy. Follow-up attention including upper endoscopy should be paid to reflux pharyngolaryngitis in patients after esophagogastrostomy as well as reflux esophagitis, because there is often a lack in symptoms regardless of high incidence of pharyngolaryngitis.
Authors:
K Nishimura; H Fujita; T Tanaka; Y Tanaka; S Matono; K Murata; H Umeno; K Shirouzu
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Publication Detail:
Type:  Journal Article     Date:  2009-06-22
Journal Detail:
Title:  Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus / I.S.D.E     Volume:  23     ISSN:  1442-2050     ISO Abbreviation:  Dis. Esophagus     Publication Date:  2010 Jan 
Date Detail:
Created Date:  2010-05-07     Completed Date:  2010-09-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8809160     Medline TA:  Dis Esophagus     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  20-6     Citation Subset:  IM    
Affiliation:
Department of Surgery, Kurume University School of Medicine, Fukuoka, Japan. koheinis@med.kurume-u.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Aged
Endoscopy, Gastrointestinal*
Esophagectomy
Esophagostomy
Female
Gastrostomy
Humans
Laryngitis / classification*,  etiology,  pathology
Male
Middle Aged
Pharyngitis / classification*,  etiology,  pathology
Regurgitation, Gastric / complications*,  pathology
Severity of Illness Index*

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