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Impact of the perioperative assessment of deglutition on postoperative respiratory complications in elderly patients undergoing gastrectomy for gastric cancer

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Abstract

Purpose

To investigate the association between perioperative deglutition screening and postoperative respiratory complications (PRCs) in elderly patients undergoing gastrectomy for gastric cancer.

Methods

We analyzed data from 86 patients with gastric cancer (aged ≥ 70 years) who underwent gastrectomy between October, 2016 and November, 2018. Videofluoroscopic swallowing examinations (VFSEs) were performed before and after surgery. We examined the association of these results with postoperative respiratory complications, as well as the relationships between demographic, operative, and swallowing function assessment data.

Results

PRCs were identified in 16 patients. The results of pre- and postoperative VFSE showed abnormalities in 28 and 32 patients, respectively. Multivariate analysis revealed that abnormalities in the postoperative VFSEs were strongly associated with the development of PRCs (P = 0.002). The findings of this analysis suggests that ventilatory impairment, a Charlson comorbidity index score ≥ 3, and an open surgical approach are independent risk factors for PRCs.

Conclusion

This is the first study to demonstrate the efficacy of perioperative assessment of swallowing function using VFSE for predicting PRCs in elderly patients undergoing gastrectomy for gastric cancer.

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Acknowledgements

We declare that no external funding was received for this study.

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Authors and Affiliations

  1. Department of Gastroenterological Surgery, Osaka General Medical Center, 3-1-56 Bandai-Higashi, Sumiyoshi-Ku, Osaka, 558-8558, Japan

    Yoshinori Hayashi, Masaaki Motoori, Yasuhiro Miyazaki, Yujiro Nishizawa, Hisateru Komatsu, Akira Inoue, Yoshinori Kagawa, Akira Tomokuni & Kazumasa Fujitani

  2. Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan

    Yoshinori Hayashi

  3. Department of Rehabilitation, Osaka General Medical Center, Osaka, Japan

    Shizuka Maekawa

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  1. Yoshinori Hayashi
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  2. Masaaki Motoori
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  3. Yasuhiro Miyazaki
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  4. Shizuka Maekawa
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  5. Yujiro Nishizawa
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Correspondence to Masaaki Motoori.

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Ethical statement

The protocol for this research project was approved by the Institutional Review Board of Osaka General Medical Center (approval number: 30-S02-003) and conforms to the provisions of the Declaration of Helsinki. Informed consent was obtained from all the participants or their guardians.

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Hayashi, Y., Motoori, M., Miyazaki, Y. et al. Impact of the perioperative assessment of deglutition on postoperative respiratory complications in elderly patients undergoing gastrectomy for gastric cancer. Surg Today 54, 258–265 (2024). https://doi.org/10.1007/s00595-023-02728-3

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  • DOI: https://doi.org/10.1007/s00595-023-02728-3

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