title: Stricture location predicts swallowing outcomes following endoscopic rendezvous procedures.
abstract: 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.
  
  
  
  Retrospective chart review.
  
  
  
  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.
  
  
  
  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).
  
  
  
  Following the endoscopic rendezvous procedure, swallowing outcomes and G-tube status is related to the distance of the stricture from the incisors.
  
  
  
  2b Laryngoscope, 127:1388-1391, 2017.
authors.affiliation: University of North Carolina Medical School, University of North Carolina Hospitals, Chapel Hill, North Carolina, U.S.A.
authors.forename: Katherine N
authors.initials: KN
authors.lastname: Adams
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of North Carolina Hospitals, Chapel Hill, North Carolina, U.S.A.
authors.forename: Rupali N
authors.initials: RN
authors.lastname: Shah
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of North Carolina Hospitals, Chapel Hill, North Carolina, U.S.A.
authors.forename: Robert A
authors.initials: RA
authors.lastname: Buckmire
mesh_terms: D000328:Adult; D000368:Aged; D059248:Chemoradiotherapy / Q000009:adverse effects; D003679:Deglutition / Q000502:physiology*; D003680:Deglutition Disorders / Q000209:etiology / Q000503:physiopathology* / Q000628:therapy; D004106:Dilatation / Q000379:methods*; D004940:Esophageal Stenosis / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D004945:Esophagoscopy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D005774:Gastrostomy / Q000706:statistics & numerical data; D006258:Head and Neck Neoplasms / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology / Q000503:physiopathology* / Q000628:therapy; D011788:Quality of Life; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Eating Assessment Tool-10; Pharyngoesophageal stricture; chemoradiotherapy; rendezvous procedure