AI Article Synopsis
- Complete pharyngoesophageal strictures often result from treatments for head and neck cancer, and a combined dilation procedure (rendezvous procedure) has been evaluated for its effectiveness in treating these strictures while assessing long-term swallowing outcomes.
- A study of 18 patients treated between 2007 and 2015 found an 83% completion rate for the procedure, with 86.7% of participants achieving an oral diet and 46.7% able to have their G-tubes removed after an average follow-up of 22 months.
- Results indicated a correlation between G-tube independence and stricture characteristics, with patients who were G-tube independent demonstrating better swallowing quality, as measured by EAT-10 scores,
Article Abstract
Objectives/hypothesis: Complete pharyngoesophageal strictures may be encountered by the otolaryngologist as a consequence of radiation/chemoradiotherapy therapies for head and neck cancer. A combined anterograde and retrograde dilation procedure (rendezvous procedure) has proven to be a useful surgical intervention in these cases. We assess the long-term swallowing outcomes of this patient cohort including gastrostomy tube (G-tube) reliance, swallowing quality of life, and variables that contribute to improved swallowing outcomes.
Study Design: Retrospective chart review.
Methods: A retrospective chart review of 18 consecutive patients treated with rendezvous procedures between April 2007 and May 2015 was carried out. Data were collected from chart review and follow-up telephone calls including demographics, surgical/postoperative course details, and Eating Assessment Tool (EAT-10) (swallowing quality of life) scores.
Results: The completion rate of the procedure was 83% (15 completed/3 procedures aborted). Average follow-up was 22 months. Thirteen of 15 (86.7%) achieved an oral diet, and 7/15 (46.7%) had their G-tube removed. G-tube-independent (GTI) patients had an average stricture length of 2.33 cm and an average distance from the incisors of 17.4 cm compared to G-tube dependent-(GTD) patients who had an average stricture length of 2.63 cm and 14.6 cm mean distance from the incisors (P = .66 and .0343, respectively). Final EAT-10 scores averaged 20.1 in GTI patients and 33.8 in GTD patients (P = .022). Stricture/incisor distance and EAT-10 scores demonstrated a moderate to strong negative correlation (r = -0.67).
Conclusions: Following the endoscopic rendezvous procedure, swallowing outcomes and G-tube status is related to the distance of the stricture from the incisors.
Level Of Evidence: 2b Laryngoscope, 127:1388-1391, 2017.
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| http://dx.doi.org/10.1002/lary.26330 | DOI Listing |
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