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Relation between functional dysphagia and vocal cord palsy after transhiatal oesophagectomy
J P Pierie1, S Goedegebuure, F A Schuerman
1Department of Surgery, Diakonessenhuis Utrecht, The Netherlands. jpierie@partners.org
Objective:
To assess the incidence, natural course, and possible pathogenesis of dysphagia that is not caused by anastomotic stricture, after transhiatal oesophagectomy and gastric tube reconstruction.
Design:
Prospective study.
Setting:
District teaching hospital, The Netherlands.
Subjects:
22 patients who had transhiatal oesophagectomy and gastric tube reconstruction for cancer.
Main Outcome Measures:
Incidence of dysphagia that is not caused by anastomotic stricture one week after operation, and presence of this functional dysphagia and correlation with vocal cord palsy at 4, 8, 12, and 16 weeks postoperatively.
Results:
The incidence of functional dysphagia was 7 out of 22 (32%); it was self-limiting in 5 out of 7 (71%) of the cases and associated with the incidence of vocal cord palsy (p = 0.0006).
Conclusion:
Functional dysphagia after transhiatal oesophagectomy occurs frequently, but is self-limiting in most patients. Injury to branches of the recurrent laryngeal nerve is a likely cause.