{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T12:42:28Z","timestamp":1789908148249,"version":"4.0.1"},"reference-count":37,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2023,12,28]],"date-time":"2023-12-28T00:00:00Z","timestamp":1703721600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Digestive Endoscopy"],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>The aging population, including patients with superficial esophageal cancer, encounters critical dysphagia\u2010 and postoperative pneumonia\u2010related issues. Although endoscopic submucosal dissection (ESD) provides advantages over other modalities, older patients are at higher risk of postoperative pneumonia. Furthermore, the etiologies of pneumonia are complex and include patient\u2010 (such as sarcopenia) and treatment\u2010 (including ESD) related factors. Therefore, this study evaluated swallowing function in patients with superficial esophageal cancer and identified post\u2010ESD pneumonia\u2010associated factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Comprehensive swallowing function and sarcopenia were evaluated in patients pre\u2010ESD and 2\u2009months post\u2010ESD using high\u2010resolution manometry and several swallowing studies by multiple experts. The effects of mucosal resection and sarcopenia on swallowing function changes post\u2010ESD, the relationship between preoperative swallowing function and sarcopenia, and the factors influencing postoperative pneumonia were investigated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twenty patients were included in the study. Patients with preoperative sarcopenia had significantly lower pharyngeal\/upper esophageal sphincter and tongue pressures than those without sarcopenia. However, ESD did not worsen pharyngeal or upper esophageal pressure. Post\u2010ESD pneumonia incidence tended to be higher in patients with sarcopenia than in those without sarcopenia. The lower upper esophageal sphincter\u2010integrated relaxation pressure (UES\u2010IRP) was a significant factor in pneumonia development. Furthermore, the receiver operating characteristic curve for UES\u2010IRP in pneumonia yielded an area under the curve of 0.82.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Sarcopenia is associated with preoperative dysphagia, which increases post\u2010ESD pneumonia risk. Therefore, postoperative pneumonia incidence is expected to increase with an aging population, making preoperative sarcopenia and swallowing function evaluation crucial.<\/jats:p><\/jats:sec>","DOI":"10.1111\/den.14715","type":"journal-article","created":{"date-parts":[[2023,11,1]],"date-time":"2023-11-01T07:39:30Z","timestamp":1698824370000},"page":"801-810","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Impact of low pharyngeal\/esophageal pressure associated with sarcopenia on postendoscopic submucosal dissection pneumonia in patients with superficial esophageal cancer"],"prefix":"10.1111","volume":"36","author":[{"given":"Yasuhiro","family":"Taniguchi","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and Hepatology Nagasaki University Graduate School of Biomedical Sciences  Nagasaki 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