Prediction of the Oral Intake with an Endoscopic Swallowing Examination in Dysphagia Patients Who Underwent Surgery for Digestive Diseases

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  • Takao Natsumi
    Department of Otorhinolaryngology-Head and Neck and Neck Surgery, Yokohama City University School of Medicine
  • Chiba Yoshihiro
    Department of Otorhinolaryngology-Head and Neck and Neck Surgery, Yokohama City University School of Medicine
  • Sano Daisuke
    Department of Otorhinolaryngology-Head and Neck and Neck Surgery, Yokohama City University School of Medicine
  • Oridate Nobuhiko
    Department of Otorhinolaryngology-Head and Neck and Neck Surgery, Yokohama City University School of Medicine

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Other Title
  • 消化器疾患術後の嚥下障害患者における嚥下内視鏡検査による経口摂取確立の予測
  • ショウカキ シッカン ジュツゴ ノ エンカ ショウガイ カンジャ ニ オケル エンカ ナイシキョウ ケンサ ニ ヨル ケイコウ セッシュ カクリツ ノ ヨソク

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<p>　The aim of this retrospective study was to assess whether the possibility of oral intake could be estimated with an endoscopic swallowing examination (VE) in patients with dysphagia after surgery for digestive diseases. The study subjects were 28 patients who had dysphagia after surgery for digestive diseases in Yokohama City University Hospital between January, 2013 and September, 2017. Oral intake status (possibility of oral intake and dependence on alternative nutrition) was evaluated up to 80 days after the first VE. The relationship between oral intake status and patient characteristics (age, sex, history of aspiration pneumonia, presence of tracheostomy, presence of vocal cord paralysis, American Society of Anesthesiologists physical status, operative time), the Hyodo score and the presence of aspiration during VE were examined. The time course for oral intake status (the start of oral intake and the transition from alternative nutrition) was also evaluated by the Kaplan-Meier method according to the Hyodo score (with a cut-off value of 6) and aspiration during VE. In the followup period for up to 80 days after the first VE, 26 patients started oral intake and the remaining 2 did not. Nine patients were dependent on alternative nutrition and 19 were not. There were no statistical differences on the final oral intake status according to the patient characteristics. At the first VE, 19 and 9 patients had a Hyodo score of ≤ 6 and >6, respectively. The numbers of patients with and without aspiration were 10 and 18, respectively. There were no statistical differences on the final oral intake status according to the indexes at the first VE. The Kaplan-Meier estimation revealed that patients with a Hyodo score >6 experienced a later start of oral intake and a slower transition from alternative nutrition than patients with a Hyodo score ≤ 6. Patients with aspiration at the first VE had a longer dependence on alternative nutrition than those without. Although the first VE after the surgery for digestive diseases was not a definitive predictor of the final oral intake status, it could predict the time course for the transition from alternative nutrition as well as the start of oral intake.</p>

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