Document Detail

Videofluoroscopic evaluation in oropharyngeal swallowing after radical esophagectomy with lymphadenectomy for esophageal cancer.
MedLine Citation:
PMID:  18214027     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: After esophagectomy a swallowing abnormality is the predominant symptom for esophageal cancer. The aims of this study were to examine (i) oropharyngeal swallowing by comparing pre- and postoperative period, and (ii) the relationship between oropharyngeal swallowing and the alimentary reconstruction route after esophagectomy. PATIENTS AND METHODS: We studied 27 patients in the upright position using videofluoroscopy in the lateral projection. Each patient was studied during 10 mL barium swallows in the pre- and post-operative period. RESULTS: Of the 27 patients studied, alimentary reconstruction with the retrosternal route (RS group) was performed in 8 patients, that with posterior mediastinal route (PM group) in 8 patients, and the intrathoracic (IT group) esophagogastrostomy inside the posterior mediastinum in 11 patients. With regard to the maximal extent of structural movement, the superior and anterior excursion of the hyoid bone was significantly reduced postoperatively among all groups. The maximal extent of the cricopharyngeal opening was significantly reduced postoperatively in the RS group, but not in the IT group. The changes in the peri-operative structural movement were the lowest in the RS group. CONCLUSION: A new-onset oropharyngeal swallowing abnormality following retrosternal reconstruction after esophagectomy may have appeared because the change in the peri-operative movement was the lowest. The results of the swallowing evaluation using videofluoroscopy suggest that to avoid oropharyngeal swallowing abnormalities the intrathoracic or cervical anastomosis with posterior mediastinal route should be chosen as reconstruction after esophagectomy if possible.
Hiroyuki Kato; Tatsuya Miyazaki; Makoto Sakai; Akihiko Sano; Naritaka Tanaka; Hitoshi Kimura; Takanori Inose; Ahmad Faried; Kana Saito; Makoto Sohda; Masanobu Nakajima; Yasuyuki Fukai; Norihiro Masuda; Minoru Fukuchi; Ryokuhei Manda; Hitoshi Ojima; Katsuhiko Tsukada; Hiroyuki Kuwano
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Anticancer research     Volume:  27     ISSN:  0250-7005     ISO Abbreviation:  Anticancer Res.     Publication Date:    2007 Nov-Dec
Date Detail:
Created Date:  2008-01-24     Completed Date:  2008-02-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8102988     Medline TA:  Anticancer Res     Country:  Greece    
Other Details:
Languages:  eng     Pagination:  4249-54     Citation Subset:  IM    
Department of General Surgical Science (Surgery I), Gunma University Graduate School of Medicine, Maebashi, Japan.
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MeSH Terms
Deglutition / physiology
Deglutition Disorders / etiology*,  radiography*
Esophageal Neoplasms / surgery*
Esophagectomy / adverse effects*,  methods
Hyoid Bone
Lymph Node Excision / adverse effects*
Reconstructive Surgical Procedures / methods*

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