{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:15:42Z","timestamp":1788221742005,"version":"build-2803163510"},"reference-count":33,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,10,12]],"date-time":"2024-10-12T00:00:00Z","timestamp":1728691200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,10,12]],"date-time":"2024-10-12T00:00:00Z","timestamp":1728691200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:p>Tongue pressure (TP) decreases significantly after esophagectomy in esophageal cancer patients (ECPs). Meanwhile, 2\u00a0weeks of gum-chewing training (GCT) significantly increased TP in healthy university students. We examined whether perioperative GCT would decrease the proportion of patients exhibiting a decline in TP at 2\u00a0weeks postoperatively, and prevent postoperative complications, in thoracic ECPs (TECPs). This was a single-center interventional study, and nonrandomized study with a historical control group (HCG). TECPs who underwent first-stage radical esophagectomy were recruited. Thirty-two patients of 40 in the gum-chewing group (GCG) were completed perioperative GCT in 3 times daily. Propensity score matching was performed with covariates related to TP including preoperative age, sex, body mass index, and the repetitive saliva swallowing test result, and yielded a matched cohort of 25 case pairs. Eleven GCG patients [44.0%] exhibited significantly lower TP at 2\u00a0weeks postoperatively than before esophagectomy was significantly fewer than that of 19 patients [76.0%] in the HCG. The median number of fever days (\u2265\u200938.0\u00a0\u00b0C) in the 2\u00a0weeks after esophagectomy in the GCG was significantly fewer than those in the HCG. Perioperative GCT may prevent postoperative TP decline and postoperative dysphagia-related complications after esophagectomy.<\/jats:p>","DOI":"10.1038\/s41598-024-74090-4","type":"journal-article","created":{"date-parts":[[2024,10,12]],"date-time":"2024-10-12T08:03:45Z","timestamp":1728720225000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Perioperative gum-chewing training prevents a decrease in tongue pressure after esophagectomy in thoracic esophageal cancer patients: a nonrandomized trial"],"prefix":"10.1038","volume":"14","author":[{"given":"Reiko","family":"Yamanaka-Kohno","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuhiro","family":"Shirakawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aya","family":"Yokoi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoaki","family":"Maeda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shunsuke","family":"Tanabe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuhiro","family":"Noma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuyoshi","family":"Shimizu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshiharu","family":"Mituhashi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshihide","family":"Nakamura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Souto","family":"Nanba","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yurika","family":"Uchida","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takayuki","family":"Maruyama","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manabu","family":"Morita","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daisuke","family":"Ekuni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,10,12]]},"reference":[{"key":"74090_CR1","doi-asserted-by":"publisher","first-page":"1010","DOI":"10.1007\/s12328-020-01237-x","volume":"13","author":"DJ Uhlenhopp","year":"2020","unstructured":"Uhlenhopp, D. J., Then, E. O., Sunkara, T. & Gaduputi, V. Epidemiology of esophageal cancer: Update in global trends, etiology and risk factors. Clin. J. Gastroenterol. 13, 1010\u20131021. https:\/\/doi.org\/10.1007\/s12328-020-01237-x (2020).","journal-title":"Clin. J. Gastroenterol."},{"key":"74090_CR2","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1007\/s00595-019-01878-7","volume":"50","author":"M Watanabe","year":"2020","unstructured":"Watanabe, M. et al. Recent progress in multidisciplinary treatment for patients with esophageal cancer. Surg. Today 50, 12\u201320. https:\/\/doi.org\/10.1007\/s00595-019-01878-7 (2020).","journal-title":"Surg. Today"},{"key":"74090_CR3","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1186\/s12957-020-01908-6","volume":"18","author":"N Maeda","year":"2020","unstructured":"Maeda, N. et al. Skeletal muscle loss in the postoperative acute phase after esophageal cancer surgery as a new prognostic factor. World J. Surg. Oncol. 18, 143. https:\/\/doi.org\/10.1186\/s12957-020-01908-6 (2020).","journal-title":"World J. Surg. Oncol."},{"key":"74090_CR4","doi-asserted-by":"publisher","first-page":"300","DOI":"10.1007\/s10388-019-00668-x","volume":"16","author":"A Yokoi","year":"2019","unstructured":"Yokoi, A. et al. Change in tongue pressure and the related factors after esophagectomy: A short-term, longitudinal study. Esophagus 16, 300\u2013308. https:\/\/doi.org\/10.1007\/s10388-019-00668-x (2019).","journal-title":"Esophagus"},{"key":"74090_CR5","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1007\/s00455-005-9011-6","volume":"21","author":"M Yoshida","year":"2006","unstructured":"Yoshida, M. et al. Decreased tongue pressure reflects symptom of dysphagia. Dysphagia 21, 61\u201365. https:\/\/doi.org\/10.1007\/s00455-005-9011-6 (2006).","journal-title":"Dysphagia"},{"key":"74090_CR6","doi-asserted-by":"publisher","first-page":"1147","DOI":"10.1007\/s00455-022-10541-2","volume":"38","author":"K Kojima","year":"2023","unstructured":"Kojima, K. et al. Perioperative decrease in tongue pressure is an intervenable predictor of aspiration after esophagectomy. Dysphagia 38, 1147\u20131155. https:\/\/doi.org\/10.1007\/s00455-022-10541-2 (2023).","journal-title":"Dysphagia"},{"key":"74090_CR7","doi-asserted-by":"publisher","first-page":"38","DOI":"10.1016\/j.jds.2018.11.002","volume":"14","author":"M Takahashi","year":"2019","unstructured":"Takahashi, M. & Satoh, Y. Effects of gum chewing training on oral function in normal adults: Part 1 investigation of perioral muscle pressure. J. Dent. Sci. 14, 38\u201346. https:\/\/doi.org\/10.1016\/j.jds.2018.11.002 (2019).","journal-title":"J. Dent. Sci."},{"key":"74090_CR8","doi-asserted-by":"publisher","first-page":"1198","DOI":"10.1212\/WNL.0b013e3181d9002b","volume":"74","author":"AR South","year":"2010","unstructured":"South, A. R., Somers, S. M. & Jog, M. S. Gum chewing improves swallow frequency and latency in Parkinson patients: A preliminary study. Neurology 74, 1198\u20131202. https:\/\/doi.org\/10.1212\/WNL.0b013e3181d9002b (2010).","journal-title":"Neurology"},{"key":"74090_CR9","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD006506.pub3","author":"V Short","year":"2015","unstructured":"Short, V. et al. Chewing gum for postoperative recovery of gastrointestinal function. Cochrane Database Syst. Rev. https:\/\/doi.org\/10.1002\/14651858.CD006506.pub3 (2015).","journal-title":"Cochrane Database Syst. Rev."},{"key":"74090_CR10","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1016\/j.ijsu.2017.07.107","volume":"47","author":"Q Liu","year":"2017","unstructured":"Liu, Q. et al. Effect of gum chewing on ameliorating ileus following colorectal surgery: A meta-analysis of 18 randomized controlled trials. Int. J. Surg. 47, 107\u2013115. https:\/\/doi.org\/10.1016\/j.ijsu.2017.07.107 (2017).","journal-title":"Int. J. Surg."},{"key":"74090_CR11","unstructured":"Toki, S. [Enjoy chewing, gum training practice]. Shikai Tenbou 135, 330\u2013335. https:\/\/mol.medicalonline.jp\/library\/journal\/download?GoodsID=aa7shitm\/2020\/013502\/011&name=0330-0335j&UserID=150.46.200.57 (2020)"},{"key":"74090_CR12","doi-asserted-by":"publisher","first-page":"6599","DOI":"10.3390\/jcm11216599","volume":"11","author":"R Ichibayashi","year":"2022","unstructured":"Ichibayashi, R., Sekiya, H., Kaneko, K. & Honda, M. Use of maximum tongue pressure values to examine the presence of dysphagia after extubation and prevent aspiration pneumonia in elderly emergency patients. J. Clin. Med. 11, 6599. https:\/\/doi.org\/10.3390\/jcm11216599 (2022).","journal-title":"J. Clin. Med."},{"key":"74090_CR13","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0239590","volume":"15","author":"M Nakamori","year":"2020","unstructured":"Nakamori, M. et al. Simplified cough test can predict the risk for pneumonia in patients with acute stroke. PLoS One 15, e0239590. https:\/\/doi.org\/10.1371\/journal.pone.0239590 (2020).","journal-title":"PLoS One"},{"key":"74090_CR14","doi-asserted-by":"publisher","first-page":"205","DOI":"10.1097\/01.sla.0000133083.54934.ae","volume":"240","author":"D Dindo","year":"2004","unstructured":"Dindo, D., Demartines, N. & Clavien, P. A. Classification of surgical complications: A new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 240, 205\u2013213. https:\/\/doi.org\/10.1097\/01.sla.0000133083.54934.ae (2004).","journal-title":"Ann Surg."},{"key":"74090_CR15","doi-asserted-by":"publisher","first-page":"187","DOI":"10.1097\/SLA.0b013e3181b13ca2","volume":"250","author":"PA Clavien","year":"2009","unstructured":"Clavien, P. A. et al. The Clavien-Dindo classification of surgical complications: Five-year experience. Ann. Surg. 250, 187\u2013196. https:\/\/doi.org\/10.1097\/SLA.0b013e3181b13ca2 (2009).","journal-title":"Ann. Surg."},{"key":"74090_CR16","unstructured":"Japan Clinical Oncology Group (JCOG), JCOG Post-operative complication criteria (Clavien-Dindo Classification), https:\/\/jcog.jp\/doctor\/tool\/clavien_dindo\/ (2013)"},{"key":"74090_CR17","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0165837","volume":"11","author":"M Nakamori","year":"2016","unstructured":"Nakamori, M. et al. Prediction of pneumonia in acute stroke patients using tongue pressure measurements. PLoS One 11, e0165837. https:\/\/doi.org\/10.1371\/journal.pone.0165837 (2016).","journal-title":"PLoS One"},{"key":"74090_CR18","doi-asserted-by":"publisher","first-page":"753","DOI":"10.3390\/clinpract13040068","volume":"13","author":"A Minoura","year":"2023","unstructured":"Minoura, A. et al. Relationships between lip seal strength, tongue pressure, and daytime sleepiness in Japanese workers: A cross-sectional study. Clin. Pract. 13, 753\u2013762. https:\/\/doi.org\/10.3390\/clinpract13040068 (2023).","journal-title":"Clin. Pract."},{"key":"74090_CR19","doi-asserted-by":"publisher","first-page":"494","DOI":"10.1007\/s10266-016-0291-0","volume":"105","author":"Y Hasegawa","year":"2017","unstructured":"Hasegawa, Y. et al. Change in tongue pressure in patients with head and neck cancer after surgical resection. Odontol. 105, 494\u2013503. https:\/\/doi.org\/10.1007\/s10266-016-0291-0 (2017).","journal-title":"Odontol."},{"key":"74090_CR20","doi-asserted-by":"publisher","first-page":"150","DOI":"10.1002\/pst.433","volume":"10","author":"PC Austin","year":"2011","unstructured":"Austin, P. C. Optimal caliper widths for propensity-score matching when estimating differences in means and differences in proportions in observational studies. Pharm. Stat. 10, 150\u2013161. https:\/\/doi.org\/10.1002\/pst.433 (2011).","journal-title":"Pharm. Stat."},{"key":"74090_CR21","doi-asserted-by":"publisher","first-page":"271","DOI":"10.1007\/s40471-017-0131-y","volume":"4","author":"JW Jackson","year":"2017","unstructured":"Jackson, J. W., Schmid, I. & Stuart, E. A. Propensity scores in pharmacoepidemiology: Beyond the horizon. Curr. Epidemiol. Rep. 4, 271\u2013280. https:\/\/doi.org\/10.1007\/s40471-017-0131-y (2017).","journal-title":"Curr. Epidemiol. Rep."},{"key":"74090_CR22","doi-asserted-by":"publisher","first-page":"1266","DOI":"10.1016\/j.jtcvs.2010.08.038","volume":"140","author":"MF Berry","year":"2010","unstructured":"Berry, M. F. et al. A Comprehensive evaluation for aspiration after esophagectomy reduces the incidence of post-operative pneumonia. J. Thorac. Cardiovasc. Surg. 140, 1266\u20131271. https:\/\/doi.org\/10.1016\/j.jtcvs.2010.08.038 (2010).","journal-title":"J. Thorac. Cardiovasc. Surg."},{"key":"74090_CR23","first-page":"328","volume":"100","author":"T Yamamoto","year":"2009","unstructured":"Yamamoto, T. & Ohuchida, T. Aspiration-related fever: Discrepancy between fever and imaging on aspiration. Fukuoka Igaku Zasshi 100, 328\u2013331 (2009).","journal-title":"Fukuoka Igaku Zasshi"},{"key":"74090_CR24","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.26334","volume":"4","author":"K Kuzuu","year":"2021","unstructured":"Kuzuu, K. et al. Gastrointestinal cancer stage at diagnosis before and during the COVID-19 pandemic in Japan. JAMA Netw. Open 4, e2126334. https:\/\/doi.org\/10.1001\/jamanetworkopen.2021.26334 (2021).","journal-title":"JAMA Netw. Open"},{"key":"74090_CR25","doi-asserted-by":"publisher","first-page":"1143","DOI":"10.1007\/s00595-021-02449-5","volume":"52","author":"T Ikeda","year":"2022","unstructured":"Ikeda, T. et al. Effectiveness of early exercise on reducing skeletal muscle loss during preoperative neoadjuvant chemotherapy for esophageal cancer. Surg. Today 52, 1143\u20131152. https:\/\/doi.org\/10.1007\/s00595-021-02449-5 (2022).","journal-title":"Surg. Today"},{"key":"74090_CR26","doi-asserted-by":"publisher","first-page":"797","DOI":"10.1007\/s10388-021-00844-y","volume":"18","author":"Y Shirakawa","year":"2021","unstructured":"Shirakawa, Y. et al. Early intervention of the perioperative multidisciplinary team approach decreases the adverse events during neoadjuvant chemotherapy for esophageal cancer patients. Esophagus 18, 797\u2013805. https:\/\/doi.org\/10.1007\/s10388-021-00844-y (2021).","journal-title":"Esophagus"},{"key":"74090_CR27","doi-asserted-by":"publisher","first-page":"378","DOI":"10.1007\/s11748-021-01757-4","volume":"70","author":"R Yamanaka-Kohno","year":"2022","unstructured":"Yamanaka-Kohno, R. et al. Patients scheduled to undergo esophageal surgery should have the highest priority for perioperative oral management triage: A cross-sectional study. Gen. Thorac. Cardiovasc. Surg. 70, 378\u2013385. https:\/\/doi.org\/10.1007\/s11748-021-01757-4 (2022).","journal-title":"Gen. Thorac. Cardiovasc. Surg."},{"key":"74090_CR28","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1007\/s10388-020-00751-8","volume":"18","author":"R Yamanaka-Kohno","year":"2021","unstructured":"Yamanaka-Kohno, R. et al. Association of dental occlusal support with the prognostic nutritional Index in patients with esophageal cancer who underwent esophagectomy. Esophagus 18, 49\u201355. https:\/\/doi.org\/10.1007\/s10388-020-00751-8 (2021).","journal-title":"Esophagus"},{"key":"74090_CR29","doi-asserted-by":"publisher","first-page":"574","DOI":"10.11607\/ijp.3622","volume":"26","author":"R Yamanaka","year":"2013","unstructured":"Yamanaka, R. et al. Occlusion and weight change in a patient after esophagectomy: Success derived from restoration of occlusal support. Int. J. Prosthodont. 26, 574\u2013576. https:\/\/doi.org\/10.11607\/ijp.3622 (2013).","journal-title":"Int. J. Prosthodont."},{"key":"74090_CR30","doi-asserted-by":"publisher","first-page":"206","DOI":"10.1016\/j.ijsu.2020.09.049","volume":"83","author":"PY Wang","year":"2020","unstructured":"Wang, P. Y. et al. Highlighting sarcopenia management for promoting surgical outcomes in esophageal cancers: Evidence from a prospective cohort study. Int. J. Surg. 83, 206\u2013215. https:\/\/doi.org\/10.1016\/j.ijsu.2020.09.049 (2020).","journal-title":"Int. J. Surg."},{"key":"74090_CR31","doi-asserted-by":"publisher","first-page":"2199","DOI":"10.3390\/cells11142199","volume":"11","author":"K Sakai","year":"2022","unstructured":"Sakai, K. et al. Association of oral function and with frailty and sarcopenia in community-dwelling older adults: A systematic review and meta-analysis. Cells 11, 2199. https:\/\/doi.org\/10.3390\/cells11142199 (2022).","journal-title":"Cells"},{"key":"74090_CR32","doi-asserted-by":"publisher","first-page":"80","DOI":"10.1007\/s00455-014-9577-y","volume":"30","author":"K Maeda","year":"2015","unstructured":"Maeda, K. & Akagi, J. Decreased tongue pressure is associated with sarcopenia and sarcopenic dysphagia in the elderly. Dysphagia 30, 80\u201387. https:\/\/doi.org\/10.1007\/s00455-014-9577-y (2015).","journal-title":"Dysphagia"},{"key":"74090_CR33","doi-asserted-by":"publisher","first-page":"7382","DOI":"10.3390\/jcm11247382","volume":"11","author":"K Okuno","year":"2022","unstructured":"Okuno, K. et al. Relationships between the nutrition status and oral measurements for sarcopenia in older Japanese adults. J. Clin. Med. 11, 7382. https:\/\/doi.org\/10.3390\/jcm11247382 (2022).","journal-title":"J. Clin. Med."}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-024-74090-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-024-74090-4","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-024-74090-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,1,31]],"date-time":"2025-01-31T18:43:39Z","timestamp":1738349019000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-024-74090-4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,10,12]]},"references-count":33,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["74090"],"URL":"https:\/\/doi.org\/10.1038\/s41598-024-74090-4","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,10,12]]},"assertion":[{"value":"2 August 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 September 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 October 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"31 January 2025","order":4,"name":"change_date","label":"Change Date","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Update","order":5,"name":"change_type","label":"Change Type","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The original online version of this Article was revised: In Abstract and in Figure 2 (c) legend, \u2018(>\u200938 \u00b0C)\u2019 has been corrected to \u2018(\u2265 38.0 \u00b0C)\u2019.","order":6,"name":"change_details","label":"Change Details","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"23886"}}