Serial changes in swallowing function in a case of dysphagia after jejunal reconstruction of the cervical esophagus: a case report

Autor: Kenshu Kawanishi, Shinichi Asamura, Kazuhide Matsunaga, Hitoshi Shiozaki, Noritaka Isogai, Peng Ying-Feng
Rok vydání: 2007
Předmět:
Zdroj: Esophagus. 4:47-51
ISSN: 1612-9067
1612-9059
DOI: 10.1007/s10388-006-0105-5
Popis: The patient was a 56-year-old woman. Cervical esophagectomy for cervical esophageal cancer with preservation of the larynx, bilateral neck dissection, and free jejunum reconstruction were performed in our hospital. The oral and anal sides of the free jejunum were reconstructed by end-to-side anastomosis. The oral-side blind pouch of the free jejunum was long, and the jejunum was atonic. We performed serial swallowing video fluorographic imaging 1 month and 6 months after surgery to quantitatively analyze (1) oral transit and pharyngeal transit time, (2) emptying times of the test diet in the free jejunum, (3) regurgitation of test diet, and (4) the minimal diameter of the free jejunum. At 1 month and 6 months after surgery, oral and pharyngeal transit time were evaluated as normal. Six months after surgery, emptying time of the test diet in the free jejunum was reduced compared with that 1 month after surgery. Six months after surgery, regurgitation of test diet from the blind pouch had decreased by approximately 36% compared with that at 1 month after surgery. Furthermore, 6 months after surgery, motility of the transferred jejunum had improved compared with that 1 month after surgery. These findings suggested that the food-transporting activity of the free jejunum recovered over time; however, the blind pouch length should be made as short as possible, and the jejunum should be anastomosed in a stretched position from the perspective of swallowing function.
Databáze: OpenAIRE
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