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Handgrip strength predicts early postoperative dysphagia after thoracoscopic–laparoscopic esophagectomy in male patients with esophageal cancer

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Abstract

Background

Dysphagia after esophagectomy, especially in the early postoperative period, remains a severe complication. The association between sarcopenia and dysphagia has received attention in geriatric non-cancer populations. This study aimed to determine the associations between sarcopenia parameters and early postoperative dysphagia after esophagectomy.

Methods

This retrospective observational study included 201 consecutive male patients undergoing thoracoscopic–laparoscopic esophagectomy (TLE) for esophageal cancer between October 2018 and December 2020. We used three sarcopenia parameters: handgrip strength (HGS), skeletal muscle index, and gait speed. Postoperative swallowing function was assessed by videofluoroscopy using the penetration–aspiration scale (PAS; range 1–8). Logistic regression analyses were used to predict factors associated with postoperative aspiration (PAS 6–8). Furthermore, we compared values in patients with symptomatic aspiration (PAS 6–7) and with silent aspiration (PAS 8).

Results

Aspiration occurred in 38 of 201 patients (18.9%). On multivariate analysis, significant predictors of aspiration included age [odds ratio (OR) 1.11; 95% confidence interval (CI) 1.05–1.17; p < 0.001], low HGS (OR 3.05; 95% CI 1.06–8.78; p = 0.039), upper third esophageal cancer (OR 2.79; 95% CI 1.03–7.54; p = 0.044) and recurrent laryngeal nerve palsy (OR 2.98; 95% CI 1.26–7.06; p = 0.013). Furthermore, among patients with aspiration (PAS 6–8), low HGS was significantly associated with silent aspiration (OR 6.43; 95% CI 1.06–39.00; p = 0.043).

Conclusions

Low HGS was significantly associated with early postoperative aspiration and impairment of airway protective reflexes after TLE.

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Acknowledgements

We thank Jane Charbonneau, DVM, from Edanz Group (https://en-author-services.edanz.com/ac) for editing a draft of this manuscript.

Funding

This study was not supported by any funding source.

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Authors and Affiliations

  1. Division of Esophageal Surgery, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan

    Daisuke Kurita, Daichi Utsunomiya, Kentaro Kubo, Yusuke Fujii, Kyohei Kanematsu, Koshiro Ishiyama, Junya Oguma & Hiroyuki Daiko

Authors
  1. Daisuke Kurita
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  2. Daichi Utsunomiya
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  3. Kentaro Kubo
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  4. Yusuke Fujii
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  6. Koshiro Ishiyama
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  7. Junya Oguma
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  8. Hiroyuki Daiko
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Corresponding author

Correspondence to Hiroyuki Daiko.

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Ethical statement

The National Cancer Center Institutional Review Board approved the current observational study (approval number: 2017–061), and the need for informed consent was waived owing to the retrospective nature of the study.

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The authors declare no conflicts of interest.

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Kurita, D., Utsunomiya, D., Kubo, K. et al. Handgrip strength predicts early postoperative dysphagia after thoracoscopic–laparoscopic esophagectomy in male patients with esophageal cancer. Esophagus 19, 586–595 (2022). https://doi.org/10.1007/s10388-022-00925-6

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  • DOI: https://doi.org/10.1007/s10388-022-00925-6

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