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KMID : 1038120230560030315
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Clinical Endoscopy
2023 Volume.56 No. 3 p.315 ~ p.324
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Efficacy of endoscopy under general anesthesia for the detection of synchronous lesions in oro-hypopharyngeal cancer
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Yoichiro Ono
Kenshi Yao
Yasuhiro Takaki
Kentaro Imamura
Akihiro Koga
Kensei Ohtsu
Takao Kanemitsu
Masaki Miyaoka
Takashi Hisabe
Toshiharu Ueki
Atsuko Ota
Hiroshi Tanabe
Seiji Haraoka
Satoshi Nimura
Akinori Iwashita
Susumu Sato
Rumie Wakasaki
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Abstract
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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.
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KEYWORD
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Anesthesia, General, Squamous cell carcinoma of the head and neck, Transoral surgery
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