A novel endoscopic surgery for dysphagia after stroke

作者：Wang, Jian; Li, Wuyi^*; Li, Yongjin; Jin, Xiaofeng; Niu, Yanyan; Tian, Xu; Huo, Hong

来源：Surgical Endoscopy and Other Interventional Techniques, 2018, 32(1): 127-133.

DOI：10.1007/s00464-017-5647-1

• Coblation
• Dysphagia
• Cricopharyngeal myotomy
• Stroke
• Esophageal pressure

Dysphagia is a common complication in stroke patients, which severely affects quality of life. This study aimed to evaluate the effectiveness and safety of temperature-controlled plasma radiofrequency (coblation)-assisted endoscopic cricopharyngeal myotomy (CAECPM) for the treatment sustained (> 6 months) dysphagia in stroke patients.
This retrospective case-control study included a total of 24 stroke patients with sustained dysphagia, who were either treated with transcervical cricopharyngeal myotomy (CPM) (n = 16) or CAECPM (n = 12). The patients' swallowing function was evaluated by the Chinese version of the swallow quality-of-life questionnaire (CSWAL-QOL), and dysphagia and aspiration was evaluated using the videofluoroscopic swallowing study (VFSS) swallowing (VFSS-SWAL) score and VSSF aspiration (VFSS-ASPI) score. In each patient, esophageal pressure and complications were also recorded.
The CSWAL-QOL score was increased and the VFSS-SWAL and VFSS-ASPI scores were reduced after CAECPM treatment. The upper esophageal sphincter pressure was significantly reduced after CAECPM. Only 1 of 12 (8.3%) patients had subcutaneous and mediastinal emphysema, and 2 patients had gastric regurgitation.
This exploratory study demonstrates that CAECPM is worth further investigation for dysphagia after stroke. CAECPM may be an effective and safe treatment for sustained dysphagia in stroke patients. Larges and prospective studies are required to validate these results.

• 出版日期2018-1
• 单位中国医学科学院北京协和医院