[Swallowing disorders after esophagectomy in thoracic esophageal cancer]

Postoperative swallowing disorders have been studied in 17 consecutive esophageal cancer patients who had undergone an esophagectomy with a lymph node dissection and a cervical anastomosis via the posterior mediastinal route. The patients were divided into two groups: those manifesting postoperative abnormal aspiration episodes (aspiration group: 6 cases), and those without such episodes (non-aspiration group: 11 cases). Pharyngoesophageal manometry and scintigraphic measurement of the oropharyngeal transit of a liquid bolus was done on 14th postoperative day and at hospital discharge. In contrast to the non-aspiration group, the aspiration group initially showed a lower mean pharyngeal contraction pressure and an uncoordinated deglutive response of the upper esophageal sphincter (UES) as well as frequent incomplete UES relaxation. However, the second examination revealed recovery of the mean pharyngeal contraction pressure, less frequent, uncoordinated UES responses in 2 cases and complete UES relaxation in the other cases, and shortened transit times. Based on these results, it thus was concluded that weak pharyngeal contraction with a UES dysfunction in postoperative patients appears to elongate the pharyngeal passage time of foods and induce episodes of abnormal aspiration.