Abstract：
Dysphagia after esophagectomy is a serious complication; however, no method has been established to accurately assess swallowing function. We evaluated the association of swallowing function tests with patients\' post-esophagectomy complications and nutritional statuses. We retrospectively reviewed the data of 95 patients with esophageal cancer who underwent esophagectomy between 2016 and 2021. We performed perioperative swallowing function tests, including the repetitive saliva swallowing test (RSST), maximum phonation time (MPT), and laryngeal elevation (LE). Patients with recurrent laryngeal nerve palsy (RLNP) and respiratory complications (RC) had significantly lower postoperative RSST scores than patients without them; the scores in patients with or without anastomotic leakage (AL) were similar. Postoperative MPT in patients with RLNP was shorter than that in patients without RLNP; however, it was similar to that in patients with or without AL and RC. LE was not associated with any complications. Patients with an RSST score ≤2 at 2 weeks post-esophagectomy had significant weight loss at 1, 6, and 12 months postoperatively compared with patients with an RSST score ≥3. The proportion of patients with severe weight loss (≥20% weight loss) within 1 year of esophagectomy was significantly greater in patients with RSST scores ≤2 than in those with RSST scores ≥3. Multivariate analysis showed that an RSST score ≤2 was the only predictor of severe post-esophagectomy weight loss. RSST scoring is a simple tool for evaluating post-esophagectomy swallowing function. A lower RSST score is associated with postoperative RLNP, RC, and poor nutritional status.
摘要：
食管切除术后吞咽困难是一种严重的并发症；然而，尚未建立准确评估吞咽功能的方法.我们评估了吞咽功能测试与患者食管切除术后并发症和营养状况的关系。我们回顾性分析了2016年至2021年间接受食管切除术的95例食管癌患者的资料。我们进行了围手术期吞咽功能测试，包括重复唾液吞咽测试（RSST），最大发声时间（MPT），和喉抬高（LE）。喉返神经麻痹（RLNP）和呼吸系统并发症（RC）患者的术后RSST评分明显低于无患者；有无吻合口漏（AL）患者的评分相似。RLNP患者的术后MPT短于无RLNP患者。这与有或没有AL和RC的患者相似。LE与任何并发症无关。与RSST评分≥3的患者相比，食管切除术后2周RSST评分≤2的患者在术后1、6和12个月体重明显下降。RSST评分≤2的患者在食管切除术后1年内体重严重下降（体重下降≥20％）的患者比例明显高于RSST评分≥3的患者。多因素分析显示，RSST评分≤2是食管癌术后体重严重下降的唯一预测因素。RSST评分是评估食管切除术后吞咽功能的简单工具。较低的RSST评分与术后RLNP相关，RC,和营养不良。
