Department of Preventive Dentistry, Division of Dentistry, Okayama University Hospital, 2-5-1 Shikata-cho, Kita-ku, Okayama-shi, Okayama, 700-8558, Japan.
Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science, 2-5-1, Shikata-cho, Kita-ku, Okayama-shi, Okayama, 700-8558, Japan.
Sci Rep. 2024 Oct 12;14(1):23886. doi: 10.1038/s41598-024-74090-4.
Tongue pressure (TP) decreases significantly after esophagectomy in esophageal cancer patients (ECPs). Meanwhile, 2 weeks of gum-chewing training (GCT) significantly increased TP in healthy university students. We examined whether perioperative GCT would decrease the proportion of patients exhibiting a decline in TP at 2 weeks postoperatively, and prevent postoperative complications, in thoracic ECPs (TECPs). This was a single-center interventional study, and nonrandomized study with a historical control group (HCG). TECPs who underwent first-stage radical esophagectomy were recruited. Thirty-two patients of 40 in the gum-chewing group (GCG) were completed perioperative GCT in 3 times daily. Propensity score matching was performed with covariates related to TP including preoperative age, sex, body mass index, and the repetitive saliva swallowing test result, and yielded a matched cohort of 25 case pairs. Eleven GCG patients [44.0%] exhibited significantly lower TP at 2 weeks postoperatively than before esophagectomy was significantly fewer than that of 19 patients [76.0%] in the HCG. The median number of fever days (> 38 °C) in the 2 weeks after esophagectomy in the GCG was significantly fewer than those in the HCG. Perioperative GCT may prevent postoperative TP decline and postoperative dysphagia-related complications after esophagectomy.
舌压(TP)在食管癌患者(ECPs)接受食管切除术后显著下降。同时,2 周的咀嚼口香糖训练(GCT)可显著增加健康大学生的 TP。我们研究了围手术期 GCT 是否会降低术后 2 周内 TP 下降患者的比例,并预防胸段 ECP(TECP)的术后并发症。这是一项单中心干预性研究,且与历史对照组(HCG)进行了非随机研究。我们招募了接受一期根治性食管切除术的 TECP。在口香糖咀嚼组(GCG)的 40 名患者中,有 32 名患者完成了每日 3 次的围手术期 GCT。使用与 TP 相关的协变量(包括术前年龄、性别、体重指数和重复唾液吞咽试验结果)进行倾向评分匹配,得出了 25 对匹配的病例。在术后 2 周内,GCG 中有 11 名患者(44.0%)的 TP 明显低于术前,显著少于 HCG 组的 19 名患者(76.0%)。GCG 中术后 2 周内发热天数(>38°C)的中位数明显少于 HCG。围手术期 GCT 可能预防术后 TP 下降和食管切除术后与吞咽困难相关的并发症。