| Project/Area Number |
18K17711
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| Research Category |
Grant-in-Aid for Early-Career Scientists
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| Allocation Type | Multi-year Fund |
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| Review Section |
Basic Section 59010:Rehabilitation science-related
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| Research Institution | The University of Tokyo |
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Principal Investigator |
Kaneoka Asako 東京大学, 医学部附属病院, 言語聴覚士 (40815106)
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| Project Period (FY) |
2018-04-01 – 2023-03-31
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| Project Status |
Completed (Fiscal Year 2022)
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| Budget Amount *help |
¥4,160,000 (Direct Cost: ¥3,200,000、Indirect Cost: ¥960,000)
Fiscal Year 2020: ¥1,040,000 (Direct Cost: ¥800,000、Indirect Cost: ¥240,000)
Fiscal Year 2019: ¥1,040,000 (Direct Cost: ¥800,000、Indirect Cost: ¥240,000)
Fiscal Year 2018: ¥2,080,000 (Direct Cost: ¥1,600,000、Indirect Cost: ¥480,000)
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| Keywords | 嚥下障害 / 食道癌 / 誤嚥性肺炎 / 嚥下造影検査 / 喉頭内視鏡検査 / 声帯運動障害 / リハビリテーション / 術後嚥下障害 / 食道亜全摘術 / 誤嚥 / 咽頭残留 / 嚥下内視鏡検査 / 摂食嚥下障害 / 食道がん / 嚥下機能評価 / スクリーニング検査 |
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| Outline of Final Research Achievements |
This study aimed to examine the pathophysiology of dysphagia after esophagectomy for esophageal cancer based on a scientific validation and to establish rehabilitative strategies: (1) systematic review on postoperative dysphagia for esophageal cancer, (2) analysis of longitudinal changes in swallowing function after esophageal cancer surgery, and (3) analysis of the effects of liquid modification and head flexion on postoperative dysphagia for esophageal cancer. A series of studies showed that after esophagectomy, laryngeal penetration and aspiration during swallowing and pharyngeal residue after swallowing occur, increasing the risk of aspiration pneumonia. It was suggested that liquid modification may reduce postoperative aspiration without aggravating pharyngeal residue, while head flexion (chin-tuck), which is widely used in clinical practice, may not alleviate swallowing symptoms in dysphagia after esophagectomy.
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| Academic Significance and Societal Importance of the Research Achievements |
本研究は、食道がん術後嚥下障害に関する既存のエビデンスをまとめ、また食道がん術前後の嚥下機能の変化を初めて経時的にとらえた。術後に喉頭侵入や誤嚥、嚥下後の咽頭残留が生じ、誤嚥性肺炎のリスクが高まるメカニズムを示した。また、液体へのとろみ付加は咽頭残留を悪化させることなく、術後の侵入や誤嚥を軽減できる可能性がある一方、臨床で一般に行われる頭部屈曲嚥下（顎引き嚥下）は嚥下症状を軽減しない可能性を提示した。この研究成果は、食道癌術後の誤嚥性肺炎予防に対する認識向上に寄与する。また、今後遷延する嚥下障害に対するエクササイズプログラムの開発にもつながる。
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