Prospective Comprehensive Swallowing Evaluation of Minimally Invasive Esophagectomies with Cervical Anastomosis: Silent Versus Vocal Aspiration

Ben-David, Kfır; Fullerton, Amy; Rossidis, Georgios; Michel, Michael; Thomas, Ryan M.; Sarosi, George A.; White, Jeff; Giordano, Christopher; Hochwald, Steven N.

doi:10.1007/s11605-015-2889-x

Cited by 11 publications

(4 citation statements)

References 16 publications

(19 reference statements)

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“…However, our study did not show any relation between hoarseness and a postoperative swallowing difficulty. In terms of the dissociation between swallowing function and clinical symptoms, a previous study has included many patients with silent aspiration who did not present with hoarseness, indicating that it may not be possible to predict swallowing difficulty on the basis of physical findings alone [7]. We believe that the results of our study support this conclusion.…”

Section: Discussionsupporting

confidence: 64%

An Investigation of Factors Related to Food Intake Ability and Swallowing Difficulty After Surgery for Thoracic Esophageal Cancer

et al. 2019

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Swallowing difficulty is among the major complications that can occur after surgery for thoracic esophageal cancer. Recurrent laryngeal nerve paralysis (RLNP) has been considered the most significant cause of a postoperative swallowing difficulty, but association between the two has not been adequately explained. We investigated the relation between postoperative RLNP and swallowing difficulty by means of video fluoroscopy. Our study included 32 patients who underwent subtotal esophagectomy for thoracic esophageal cancer at St. Marianna University School of Medicine between April 2014 and March 2017. We evaluated patients’ age and sex, disease stage, preoperative presence of a swallowing difficulty, nutritional status, extent and duration of surgery, blood loss volume, and postoperative presence of RLNP and/or hoarseness. Patients were divided into two groups according to whether oral food intake was possible when video fluoroscopy was performed on postoperative day (POD) 7, and we analyzed the associated factors. Postoperative RLNP occurred in 21 patients (65.6%); hoarseness occurred in 19 (59.4%). Eleven patients (34.4%) suffered swallowing difficulty that prevented food intake. No significant association was found between postoperative swallowing difficulty and postoperative RLNP or hoarseness, but a significant relation was found between the prognostic nutritional index and intraoperative lymph node dissection. Multivariable analysis revealed a significant relation between postoperative swallowing difficulty and only one factor: cervical lymph node dissection ( P = 0.0075). There appears to be no relation between RLNP pursuant to esophageal cancer surgery and swallowing difficulty that prevents oral food intake.

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Section: Discussionsupporting

confidence: 64%

An Investigation of Factors Related to Food Intake Ability and Swallowing Difficulty After Surgery for Thoracic Esophageal Cancer

et al. 2019

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“…Although this procedure has been accepted by thoracic surgeons as safe and with minimal side effects, the results of the analyses performed here indicate otherwise. Experience from other cervical surgeries and their impact on swallowing function is well known and documented [9, 10]. Problems with swallowing after these operations exist even in patients with intact recurrent nerve function at the end of the operation.…”

Section: Discussionmentioning

confidence: 99%

Concomitant Mediastinoscopy Increases the Risk of Postoperative Pneumonia After Pulmonary Lobectomy

et al. 2018

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“…It is important to mention that if the cervical anastomosis is too proximal, reaching up to the pharynx, the swallowing is more hesitant and associated with a higher risk of tracheobronchial aspiration. Also, the cervical anastomotic leak does not imply a vital prognosis, eventual healing with stenosis is treated with endoscopic dilations (41).…”

Section: Discussionmentioning

confidence: 99%

Use of the Stomach in Esophageal Reconstructive Surgery in Era of Minimally Invasive Approach

Constantinoiu¹,

Achim²,

Constantin³

2018

chr

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Esophagectomy is standard indication for surgical treatment of resectable esophageal cancer, but it can also be performed for the management of benign conditions. Esophagectomy is followed by esophageal reconstruction using other parts of the digestive tract and is associated with increased postoperative morbidity and mortality. Gastric interposition with intrathoracic or cervical esophago-gastric anastomosis is currently the preferred technique for reconstruction after esophagectomy. The incidence of esophagectomy performed by the minimal invasive approach has increased in recent years due to the advanced technology of endoscopic surgery and image enhancement that provides a better estimate of anatomical plans, facilitates access to narrow spaces and more precise dissection with less tissue trauma. Randomized clinical trials have found a significant reduction in postoperative respiratory complications, decreased hospital stay and equivalent oncological results to open esophagectomy. We present the operative technique of minimally invasive esophagectomy performed in our clinic by three-stage modified McKeown approach thoracoscopic, laparoscopic and cervical with esophageal reconstruction with stomach.

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Prospective Comprehensive Swallowing Evaluation of Minimally Invasive Esophagectomies with Cervical Anastomosis: Silent Versus Vocal Aspiration

Abstract: Swallowing dysfunction remains a common problem after minimally invasive esophagectomy (MIE) with cervical anastomosis and can be readily identified. Silent aspiration likely contributes to pneumonia after MIE.

Cited by 11 publications

References 16 publications

An Investigation of Factors Related to Food Intake Ability and Swallowing Difficulty After Surgery for Thoracic Esophageal Cancer

An Investigation of Factors Related to Food Intake Ability and Swallowing Difficulty After Surgery for Thoracic Esophageal Cancer

Concomitant Mediastinoscopy Increases the Risk of Postoperative Pneumonia After Pulmonary Lobectomy

Use of the Stomach in Esophageal Reconstructive Surgery in Era of Minimally Invasive Approach

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