Degree of pharyngeal deformation caused by pharyngeal endoscopic submucosal dissection is associated with the incidence of aspiration pneumonia

Author:

Abe Makoto1,Kawahara Yoshiro1,Obayashi Yuka12,Baba Yuki13,Hamada Kenta1,Sakae Hiroyuki1,Kono Yoshiyasu1,Kanzaki Hiromitu1,Iwamuro Masaya1,Kawano Seiji1,Makino Takuma4,Noda Yohei4,Marunaka Hidenori4,Okada Hiroyuki1

Affiliation:

1. Department of Gastroenterology, Okayama University Hospital, Okayama, Japan

2. Department of Internal Medicine, Hiroshima City Hospital, Hiroshima, Japan

3. Department of Gastroenterology, Mitoyo General Hospital, Kagawa, Japan

4. Department of Otolaryngology-Head & Neck Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan

Abstract

Abstract Background and study aims Endoscopic submucosal dissection (ESD) is one of the most minimally invasive treatments for superficial squamous cell cancer of the pharynx. However, aspiration pneumonia (AsP) associated with postoperative deformity of the pharynx may occur. The purpose of this study was to investigate the frequency of AsP and the degree of pharyngeal deformity after pharyngeal ESD. Patients and methods This was a retrospective observational study of patients who underwent pharyngeal ESD at Okayama University Hospital between 2006 and 2017. The degree of pharyngeal deformation was assessed using the pharyngeal deformation grade (PDG). The primary endpoint was the frequency of AsP as a long-term adverse event. Results Among the 52 patients enrolled, nine developed aspiration pneumonia, with a 3-year cumulative incidence of 9.0 % (95 % confidence interval [CI], 3.3 %–22.0 %). There were 16, 18, 16, and two patients that had PDG 0, 1, 2, and 3, respectively. Patients with a history of radiotherapy, as a treatment of head and neck cancer (44.4 % vs. 11.6 %; P = 0.02) and the high PDG group (PDG 2 and 3) (77.8 % vs. 25.6 %; P = 0.005) had a significantly higher incidence of AsP. The 3-year cumulative incidence rate of AsP after ESD in the high PDG group was significantly higher than that in the low PDG group (PDG 0 and 1) (23.9 % [95 %CI, 9.2.–49.5%] vs. 0 %; P = 0.03). Conclusions The incidence of aspiration pneumonia in the long-term course after pharyngeal ESD was revealed. The incidence of aspiration pneumonia may be associated with pharyngeal deformity, but further studies are needed.

Publisher

Georg Thieme Verlag KG

Subject

Obstetrics and Gynecology

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