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Change in tongue pressure and the related factors after esophagectomy: a short-term, longitudinal study

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Abstract

Background

Dysphagia is a prominent symptom after esophagectomy and may cause aspiration pneumonia. Swallowing evaluation after esophagectomy can predict and help control the incidence of postoperative pneumonia. The aim of this study was to clarify whether the change in tongue pressure was associated with any related factor and postoperative dysphagia/pneumonia in patients with esophageal cancer after esophagectomy.

Methods

Fifty-nine inpatients (41 males and 18 females; 33–77 years old) who underwent esophagectomy participated in this study. Measurement of tongue pressure and the repetitive saliva swallowing test (RSST) was performed before esophagectomy (baseline) and at 2 weeks postoperatively. The general data were collected from patients’ medical records, including sex, age, type of cancer, cancer stage, location of cancer, operative approach, history of previous chemotherapy, surgical duration, amount of bleeding during surgery, incidences of postoperative complications, intubation period, period between surgery and initiation of oral alimentation, and intensive care unit (ICU) stay, blood chemical analysis, and lifestyle.

Results

Tongue pressure decreased significantly after esophagectomy (p = 0.011). The decrease of tongue pressure was significantly associated with length of ICU stay and preoperative tongue pressure on multiple regression analysis (p < 0.05). The decrease of tongue pressure in the RSST < 3 or postoperative pneumonia (+) group was significantly greater than in the RSST ≥ 3 (p = 0.003) or pneumonia (−) group (p = 0.021).

Conclusions

The decrease in tongue pressure was significantly associated with the length of ICU stay, preoperative tongue pressure, and the incidence of dysphagia and pneumonia among inpatient after esophagectomy.

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Acknowledgements

This work was supported by Grants-in-Aid for Scientific Research (no. 15K11416) from the Ministry of Education, Culture, Sports, Science and Technology, Tokyo, Japan.

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Authors and Affiliations

  1. Department of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan

    Aya Yokoi, Daisuke Ekuni & Manabu Morita

  2. Advanced Research Center for Oral and Craniofacial Sciences, Okayama University Dental School, 2-5-1 Shikata-cho, Kita-ku, Okayama, Japan

    Daisuke Ekuni

  3. Division of Hospital Dentistry, Central Clinical Department, Okayama University Hospital, 2-5-1 Shikata-cho, Kita-ku, Okayama, Japan

    Reiko Yamanaka

  4. Department of Dentistry and Oral Surgery, National Hospital Organization Hokkaido Cancer Center, 5-7-1-1 Yamanote, Nishi-ku, Sapporo, Japan

    Hironobu Hata

  5. Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, Japan

    Yasuhiro Shirakawa

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  1. Aya Yokoi
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  2. Daisuke Ekuni
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Corresponding author

Correspondence to Daisuke Ekuni.

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Conflict of interest

Aya Yokoi, Daisuke Ekuni, Reiko Yamanaka, Hironobu Hata, Yasuhiro Shirakawa, and Manabu Morita declare that they have no conflict of interest.

Ethical Statement

All procedures followed were in accordance with the ethical standards of the responsible committees on human experimentation (institutional and national) and with the Helsinki Declaration of 1964 and later versions.

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Written, informed consent was obtained from all patients for inclusion in the study.

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Yokoi, A., Ekuni, D., Yamanaka, R. et al. Change in tongue pressure and the related factors after esophagectomy: a short-term, longitudinal study. Esophagus 16, 300–308 (2019). https://doi.org/10.1007/s10388-019-00668-x

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  • DOI: https://doi.org/10.1007/s10388-019-00668-x

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