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Perioperative Decrease in Tongue Pressure is an Intervenable Predictor of Aspiration After Esophagectomy.

Kazuhiro Kojima1, Takuya Fukushima1, Daisuke Kurita2

  • 1Department of Musculoskeletal Oncology and Rehabilitation, National Cancer Center Hospital, Tokyo, Japan.

Dysphagia
|December 1, 2022
PubMed
Summary

A decrease in tongue pressure after esophagectomy surgery is linked to aspiration pneumonia. Interventions to maintain tongue pressure may reduce this risk in patients undergoing esophageal cancer surgery.

Keywords:
AspirationDeglutitionDeglutition disordersEsophageal cancerEsophagectomyTongue pressure

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Area of Science:

  • Gastroenterology and Hepatology
  • Surgical Oncology
  • Pulmonology

Background:

  • Aspiration pneumonia is a serious complication following minimally invasive esophagectomies.
  • Understanding predictors of aspiration is crucial for improving patient outcomes after esophageal cancer surgery.

Purpose of the Study:

  • To investigate the association between perioperative tongue pressure changes and postoperative aspiration in patients undergoing thoracoscopic-laparoscopic esophagectomy.
  • To identify the cut-off value for tongue pressure changes predictive of aspiration.

Main Methods:

  • Retrospective observational study of 216 patients undergoing thoracoscopic-laparoscopic esophagectomy.
  • Tongue pressure measured preoperatively and on postoperative day 6; perioperative changes assessed.
  • Logistic regression and ROC curve analysis to identify aspiration predictors.

Main Results:

  • Perioperative decrease in tongue pressure (OR 0.92), advanced age (OR 1.07), and recurrent laryngeal nerve palsy (OR 3.04) were significantly associated with aspiration.
  • The cut-off value for perioperative tongue pressure change predicting aspiration was a decrease of 6.58%.
  • Decreased tongue pressure independently predicted aspiration, irrespective of age or nerve palsy.

Conclusions:

  • Perioperative tongue pressure decrease is a significant, modifiable predictor of acute aspiration post-esophagectomy.
  • Rehabilitation strategies targeting tongue pressure may mitigate aspiration risk.
  • Early identification and intervention for tongue pressure decline are essential for patient recovery.