2022 Volume 26 Issue 1 Pages 3-9
Purpose: Tongue pressure is measured in order to estimate swallowing function, and it decreases after esophagectomy. Its decrease is associated with the period of fasting and duration in intensive care unit (ICU). However, the decrease in tongue pressure is unknown in gastrectomy, which requires less surgical invasion for tissues related to swallowing function than esophagectomy. Screening tests for swallowing are the focus in gastric cancer patients. The aim of this study was to compare postoperative tongue pressure between patients with gastric cancer and those with esophageal cancer.
Methods: We analyzed the data of 40 inpatients (26 males and 14 females; 40–88 years old) who underwent gastrectomy/esophagectomy and an evaluation of swallowing function at Okayama University Hospital and Hokkaido Cancer Center. The gastric and esophageal cancer patients were matched for age, sex, tongue pressure before operation (baseline), repetitive saliva swallowing test (RSST) and cancer stage. For evaluation of swallowing function, tongue pressure and RSST were measured at baseline, and at 1 and 2 weeks postoperatively. Data related to tongue pressure were collected from patients’ medical records, including sex, age, cancer stage, operative approach, surgical duration, amount of bleeding during surgery, duration of intubation, fasting, ICU stay, and lifestyle. The rate and change in tongue pressure were analyzed using the two-way ANOVA test and Wilcoxon signed-rank test between gastric and esophageal cancer patients. The related factors of tongue pressure were analyzed using the Mann-Whitney U test and χ2 test.
Results: The rate of tongue pressure decrease after gastrectomy was significantly smaller than that after esophagectomy (p＝.026). In gastric cancer patients, surgical duration (p＜.001), length of ICU stay (p＜.001) and fasting after gastrectomy (p＜.001) were significantly shorter than those in esophageal cancer patients.
Discussion: These results may be related to the distance between the surgical field and tissues related to swallowing function such as the oral cavity, pharynx and larynx, and shorter periods of surgery, ICU stay and fasting after gastrectomy than esophagectomy.
Conclusions: The rate of decrease in tongue pressure in gastric cancer patients was smaller than that in esophageal cancer patients.
