Department of Gastroenterological Surgery, Osaka General Medical Center, 3-1-56 Bandai-Higashi, Sumiyoshi-Ku, Osaka, 558-8558, Japan.
Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan.
Surg Today. 2024 Mar;54(3):258-265. doi: 10.1007/s00595-023-02728-3. Epub 2023 Jul 17.
To investigate the association between perioperative deglutition screening and postoperative respiratory complications (PRCs) in elderly patients undergoing gastrectomy for gastric cancer.
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.
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.
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.
研究围手术期吞咽筛查与老年胃癌患者胃切除术后呼吸系统并发症（PRCs）之间的关系。
我们分析了 2016 年 10 月至 2018 年 11 月期间接受胃切除术的 86 例胃癌（年龄≥70 岁）患者的数据。在术前和术后进行视频透视吞咽检查（VFSE）。我们检查了这些结果与术后呼吸系统并发症的关系，以及人口统计学、手术和吞咽功能评估数据之间的关系。
16 例患者发生 PRC。VFSE 的术前和术后结果分别显示 28 例和 32 例存在异常。多变量分析显示，术后 VFSE 异常与 PRC 的发生密切相关（P=0.002）。该分析结果表明，通气障碍、Charlson 合并症指数评分≥3 以及开放性手术方法是 PRC 的独立危险因素。
这是第一项研究，证明使用 VFSE 对接受胃癌胃切除术的老年患者进行围手术期吞咽功能评估可预测 PRC 的有效性。
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