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Functional outcome assessment of swallowing (FOAMS) scoring and videofluoroscopic evaluation of perioperative swallowing rehabilitation in radical esophagectomy

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Abstract

Purpose

Oropharyngeal swallowing dysfunction following esophagectomy has been associated with the surgical disruption of muscle strength and flexibility of the oropharyngeal structures. We assessed the value of perioperative swallowing rehabilitation (SR) in patients who underwent radical esophagectomy.

Methods

We instituted routine perioperative SR for patients with esophageal cancer and retrospectively compared postoperative swallowing function between the patients who received (n = 12) vs. those who did not receive (n = 14) SR.

Results

The average duration of pre- and postoperative SR was 23.0 and 26.0 days, respectively. Preoperatively, the functional outcome assessment of the swallowing (FOAMS) score was 7 (full marks) in all 26 patients, whereas the average score at hospital discharge was 6.3 vs. 5.5 in the patients who received vs. those who did not receive SR, respectively (p = 0.049). Videofluoroscopic examination (n = 12) demonstrated that the maximum superior excursion of hyoid bone increased significantly with preoperative SR (p = 0.030), as well as postoperative SR (p = 0.046). However, perioperative SR did not reduce the incidence of postoperative aspiration pneumonia or the duration of hospital stay.

Conclusions

Swallowing function after radical esophagectomy was improved by perioperative SR; however, further investigations are needed to assess the clinical significance of SR in reducing surgical complications.

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Acknowledgments

We thank the Surgical Nursing Team at Toyama University Hospital for instructing and supporting the patients: Ms. M. Nagaki, Ms. J Matsushima, Ms. K Jozuka, and Ms. M Matsuda. We also thank Ms. Keiko Yago of the Dietary and Nutrition Service at Toyama University Hospital for preparing the Iopamidol Jelly. This work was supported in part by a Grant-in-Aid for Scientific Research (C) MEXT KAKENHI Grant Number 23591920.

Conflict of interest

We declare no conflicts of interest relating to this research.

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Authors and Affiliations

  1. Department of Surgery and Science, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Sugitani 2630, Toyama, 930-0194, Japan

    Tomoyuki Okumura, Yutaka Shimada, Toru Watanabe, Takuya Nagata & Kazuhiro Tsukada

  2. Department of Nanobio Drug Discovery, Graduate School of Pharmaceutical Sciences, Kyoto University, Yoshida Shimoadachicho 46-29, Sakyo-ku, Kyoto, 606-8501, Japan

    Yutaka Shimada

  3. Department of Oral and Maxillofacial Surgery, Toyama University Hospital, Sugitani 2630, Toyama, 930-0194, Japan

    Naomi Nakamichi

Authors
  1. Tomoyuki Okumura
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  2. Yutaka Shimada
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  3. Toru Watanabe
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  4. Naomi Nakamichi
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  5. Takuya Nagata
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  6. Kazuhiro Tsukada
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Correspondence to Tomoyuki Okumura.

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Okumura, T., Shimada, Y., Watanabe, T. et al. Functional outcome assessment of swallowing (FOAMS) scoring and videofluoroscopic evaluation of perioperative swallowing rehabilitation in radical esophagectomy. Surg Today 46, 543–551 (2016). https://doi.org/10.1007/s00595-015-1203-6

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  • DOI: https://doi.org/10.1007/s00595-015-1203-6

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