Swallowing biomechanics and upper esophageal sphincter pressure remain altered after esophagectomy for thoracic esophageal cancer
Abstract
Postoperative dysphagia is common after esophagectomy for thoracic esophageal cancer, but its long-term mechanisms remain poorly understood. This prospective study evaluated longitudinal changes in swallowing function and pressure dynamics through 6 months postoperatively. Thirteen patients who underwent subtotal esophagectomy with gastric conduit reconstruction were assessed preoperatively and at 1, 3, and 6 months postoperatively using a videofluoroscopic swallowing study (VFSS), fiberoptic endoscopic evaluation of swallowing (FEES), and the Eating Assessment Tool-10 (EAT-10). High-resolution manometry (HRM) was performed preoperatively and at 6 months postoperatively. EAT-10 scores increased significantly at 1 and 3 months, while the median score remained above baseline at 6 months without reaching statistical significance. VFSS demonstrated significant reductions in laryngeal elevation distance (LED) and hyoid forward displacement at 6 months. HRM revealed a significant increase in upper esophageal sphincter integrated relaxation pressure (UES-IRP), whereas meso-hypopharyngeal contractile integral (MHPCI) was unchanged. LED was negatively correlated with UES-IRP. Additional analyses showed no significant relationships between EAT-10 and LED or UES-IRP. Exploratory regression analyses suggested an association between anastomotic stricture and higher 6 months EAT-10 scores. These findings indicate that objective biomechanical abnormalities may persist despite an unclear relationship with patient-reported symptoms, supporting multimodal assessment using subjective and objective measures.
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BibTeX
@article{ono2026swallowing,
title = {{Swallowing biomechanics and upper esophageal sphincter pressure remain altered after esophagectomy for thoracic esophageal cancer}},
author = {Junki Ono and Hideaki Nishi and Mari Ikenaga and Shinichiro Kobayashi and Kengo Kanetaka and Noriaki Makimoto and Sumie Takashima and Ayaka Mori and Mayuko Nakamura and Yuki Morotomi and Kosuke Sawase and Shuntaro Soejima and Yoshihiko Kumai},
journal = {Scientific Reports},
year = {2026},
month = nov,
doi = {10.1038/s41598-026-78065-5},
url = {https://www.nature.com/articles/s41598-026-78065-5},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Swallowing biomechanics and upper esophageal sphincter pressure remain altered after esophagectomy for thoracic esophageal cancer
AU - Junki Ono
AU - Hideaki Nishi
AU - Mari Ikenaga
AU - Shinichiro Kobayashi
AU - Kengo Kanetaka
AU - Noriaki Makimoto
AU - Sumie Takashima
AU - Ayaka Mori
AU - Mayuko Nakamura
AU - Yuki Morotomi
AU - Kosuke Sawase
AU - Shuntaro Soejima
AU - Yoshihiko Kumai
PY - 2026
DA - 2026/11/04
JO - Scientific Reports
DO - 10.1038/s41598-026-78065-5
UR - https://www.nature.com/articles/s41598-026-78065-5
AB - Postoperative dysphagia is common after esophagectomy for thoracic esophageal cancer, but its long-term mechanisms remain poorly understood. This prospective study evaluated longitudinal changes in swallowing function and pressure dynamics through 6 months postoperatively. Thirteen patients who underwent subtotal esophagectomy with gastric conduit reconstruction were assessed preoperatively and at 1, 3, and 6 months postoperatively using a videofluoroscopic swallowing study (VFSS), fiberoptic endoscopic evaluation of swallowing (FEES), and the Eating Assessment Tool-10 (EAT-10). High-resolution manometry (HRM) was performed preoperatively and at 6 months postoperatively. EAT-10 scores increased significantly at 1 and 3 months, while the median score remained above baseline at 6 months without reaching statistical significance. VFSS demonstrated significant reductions in laryngeal elevation distance (LED) and hyoid forward displacement at 6 months. HRM revealed a significant increase in upper esophageal sphincter integrated relaxation pressure (UES-IRP), whereas meso-hypopharyngeal contractile integral (MHPCI) was unchanged. LED was negatively correlated with UES-IRP. Additional analyses showed no significant relationships between EAT-10 and LED or UES-IRP. Exploratory regression analyses suggested an association between anastomotic stricture and higher 6 months EAT-10 scores. These findings indicate that objective biomechanical abnormalities may persist despite an unclear relationship with patient-reported symptoms, supporting multimodal assessment using subjective and objective measures.
SN - 2045-2322
ER -