Clinical Endoscopy

The Korean Society of Gastrointestinal Endoscopy (대한소화기내시경학회)
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Efficacy of endoscopy under general anesthesia for the detection of synchronous lesions in oro-hypopharyngeal cancer

  • Yoichiro Ono (Department of Gastroenterology, Fukuoka University Chikushi Hospital) ;
  • Kenshi Yao (Department of Endoscopy, Fukuoka University Chikushi Hospital) ;
  • Yasuhiro Takaki (Department of Gastroenterology, Ashiya Central Hospital) ;
  • Satoshi Ishikawa (Department of Gastroenterology, Ashiya Central Hospital) ;
  • Kentaro Imamura (Department of Gastroenterology, Fukuoka University Chikushi Hospital) ;
  • Akihiro Koga (Department of Gastroenterology, Fukuoka University Chikushi Hospital) ;
  • Kensei Ohtsu (Department of Gastroenterology, Fukuoka University Chikushi Hospital) ;
  • Takao Kanemitsu (Department of Endoscopy, Fukuoka University Chikushi Hospital) ;
  • Masaki Miyaoka (Department of Endoscopy, Fukuoka University Chikushi Hospital) ;
  • Takashi Hisabe (Department of Gastroenterology, Fukuoka University Chikushi Hospital) ;
  • Toshiharu Ueki (Department of Gastroenterology, Fukuoka University Chikushi Hospital) ;
  • Atsuko Ota (Department of Pathology, Fukuoka University Chikushi Hospital) ;
  • Hiroshi Tanabe (Department of Pathology, Fukuoka University Chikushi Hospital) ;
  • Seiji Haraoka (Department of Pathology, Fukuoka University Chikushi Hospital) ;
  • Satoshi Nimura (Department of Pathology, Fukuoka University Chikushi Hospital) ;
  • Akinori Iwashita (Department of Pathology, Fukuoka University Chikushi Hospital) ;
  • Susumu Sato (Department of Otorhinolaryngology, Fukuoka University Chikushi Hospital) ;
  • Rumie Wakasaki (Department of Anesthesiology, Fukuoka University Chikushi Hospital)
  • Received : 2022.02.03
  • Accepted : 2022.04.19
  • Published : 2023.05.30
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Abstract

Background/Aims: Image-enhanced endoscopy can detect superficial oro-hypopharyngeal squamous cell carcinoma; however, reliable endoscopy of the pharyngeal region is challenging. Endoscopy under general anesthesia during transoral surgery occasionally reveals multiple synchronous lesions that remained undetected on preoperative endoscopy. Therefore, we aimed to determine the lesion detection capability of endoscopy under general anesthesia for superficial oro-hypopharyngeal squamous cell carcinoma. Methods: This retrospective study included 63 patients who underwent transoral surgery for superficial oropharyngeal squamous cell carcinoma between April 2005 and December 2020. The primary endpoint was to compare the lesion detection capabilities of preoperative endoscopy and endoscopy under general anesthesia. Other endpoints included the comparison of clinicopathological findings between lesions detected using preoperative endoscopy and those newly detected using endoscopy under general anesthesia. Results: Fifty-eight patients (85 lesions) were analyzed. The mean number of lesions per patient detected was 1.17 for preoperative endoscopy and 1.47 for endoscopy under general anesthesia. Endoscopy under general anesthesia helped detect more lesions than preoperative endoscopy did (p<0.001). The lesions that were newly detected on endoscopy under general anesthesia were small and characterized by few changes in color and surface ruggedness. Conclusions: Endoscopy under general anesthesia for superficial squamous cell carcinoma is helpful for detecting multiple synchronous lesions.

Keywords

Acknowledgement

The authors thank the laboratory staff for their excellent technical support.

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