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A novel endoscopic surgery for dysphagia after stroke

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Abstract

Background

Dysphagia is a common complication in stroke patients, which severely affects quality of life. This study aimed to evaluate the effectiveness and safety of temperature-controlled plasma radiofrequency (coblation)-assisted endoscopic cricopharyngeal myotomy (CAECPM) for the treatment sustained (>6 months) dysphagia in stroke patients.

Methods

This retrospective case-control study included a total of 24 stroke patients with sustained dysphagia, who were either treated with transcervical cricopharyngeal myotomy (CPM) (n = 16) or CAECPM (n = 12). The patients’ swallowing function was evaluated by the Chinese version of the swallow quality-of-life questionnaire (CSWAL-QOL), and dysphagia and aspiration was evaluated using the videofluoroscopic swallowing study (VFSS) swallowing (VFSS-SWAL) score and VSSF aspiration (VFSS-ASPI) score. In each patient, esophageal pressure and complications were also recorded.

Results

The CSWAL-QOL score was increased and the VFSS-SWAL and VFSS-ASPI scores were reduced after CAECPM treatment. The upper esophageal sphincter pressure was significantly reduced after CAECPM. Only 1 of 12 (8.3%) patients had subcutaneous and mediastinal emphysema, and 2 patients had gastric regurgitation.

Conclusion

This exploratory study demonstrates that CAECPM is worth further investigation for dysphagia after stroke. CAECPM may be an effective and safe treatment for sustained dysphagia in stroke patients. Larges and prospective studies are required to validate these results.

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Acknowledgement

This study was supported by a grant from the National Natural Science Foundation (No: H1301 81300816).

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Authors and Affiliations

  1. Department of Otorhinolaryngology, Peking Union Medical College Hospital, BeiJing, 100730, China

    Jian Wang, Wuyi Li, Yongjin Li, Xiaofeng Jin, Yanyan Niu, Xu Tian & Hong Huo

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  1. Jian Wang
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  2. Wuyi Li
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  3. Yongjin Li
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  4. Xiaofeng Jin
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  5. Yanyan Niu
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  6. Xu Tian
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  7. Hong Huo
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Correspondence to Wuyi Li.

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Conflict of interest

Jian Wang, Wuyi Li, Yongjin Li, Xiaofeng Jin, Yanyan Niu, Xu Tian, and Hong Huo declare that they have no conflicts of interest or financial ties to disclose.

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Wang, J., Li, W., Li, Y. et al. A novel endoscopic surgery for dysphagia after stroke. Surg Endosc 32, 127–133 (2018). https://doi.org/10.1007/s00464-017-5647-1

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  • DOI: https://doi.org/10.1007/s00464-017-5647-1

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