Combination of preoperative pulmonary and nutritional preparation for esophagectomy

Agrelli, Taciana Freitas; Borges, Marisa de Carvalho; Cunha, Fernanda Maria Rodrigues da; Silva, Élida Mara Carneiro da; Júnior, Júverson Alves Terra; Crema, Eduardo

doi:10.1590/s0102-865020180010000007

Cited by 6 publications

(3 citation statements)

References 25 publications

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“…In addition to minimizing surgical risks, evaluation and preoperative care are important to prevent postoperative complications [13,14]. We did not find in the literature studies that evaluated MIP and MEP The preoperative MEP was 76 [60-120] and was significantly lower than the predicted value (87.54 [79.61-140.19]) (p=0.001).…”

Section: Discussionmentioning

confidence: 89%

Pre- and postoperative respiratory muscle strength, body mass index and fasting glucose profile of patients with type 2 diabetes mellitus submitted to metabolic surgery

et al. 2020

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Introduction: The lung is considered a target organ in diabetes mellitus as a consequence of alterations secondary to chronic hyperglycemia that compromise respiratory muscle strength. Metabolic surgery for improving diabetes mellitus has beneficial effects on weight loss and glucose metabolism. Objective: The objective of this study was to evaluate the respiratory muscle strength, assessed by MIP and MEP, body mass index (BMI) and fasting glucose profile of patients with type 2 diabetes mellitus before and after metabolic surgery without gastric resection. Method: Seventeen patients with type 2 diabetes mellitus participated in the study. The participants had a mean age of 44.8 ± 11.81 years. Results: The results showed a significant decrease of MEP values in the immediate postoperative period when compared to the preoperative period (p=0.001), while no significant results were obtained for MIP. Regarding BMI and fasting glucose, significant weight loss and a significant reduction in fasting glucose levels were observed in the late postoperative period (p=0.006 and p=0.007, respectively). Conclusion: The MIP and MEP were reestablished and satisfactory results were obtained for BMI and fasting glucose in the late postoperative period. Further studies are needed to monitor patients in the pre- and postoperative period of metabolic surgery, identifying complications and acting on the care and recovery of these patients.

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Section: Discussionmentioning

confidence: 89%

Pre- and postoperative respiratory muscle strength, body mass index and fasting glucose profile of patients with type 2 diabetes mellitus submitted to metabolic surgery

et al. 2020

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“…Additionally, multimodal cancer prehabilitation programs are recommended to promote the therapeutic benefits of esophageal surgery (24). Notably, nutritional support and physical exercise are prerequisites for rebuilding peripheral protein mass and improving surgical outcomes (25), exercise of the respiratory muscles promotes respiratory function and reduces pulmonary complications (26), and the preoperative reversal of low serum albumin levels should promote incision healing and reduce the incidence of anastomotic complications (27).…”

Section: Discussionmentioning

confidence: 99%

Nutritional assessment in esophageal fast-track surgery: comparisons of 4 objective malnutrition screening tools

Hua¹,

Shi²,

Yu³

et al. 2022

Ann Transl Med

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Background: This cohort study aimed to compare the performance of the 2015 diagnostic criteria for malnutrition of the European Society of Clinical Nutrition and Metabolism (ESPEN), the Nutritional Risk Screening 2002 (NRS 2002), Malnutrition Universal Screening Tool (MUST), and Short-Form of Mini-Nutritional Assessment (MNA-SF) in detecting malnutrition risk and predicting postoperative complications and the failure of early oral feeding (EOF) programs in esophageal cancer patients. Methods:The 4 tools were used to conduct malnutrition assessments before surgery. The patients were divided into the groups of severe malnutrition and mild/moderate malnutrition and the incidences of the endpoints were observed. Multivariable logistic regression and receiver operating characteristic (ROC) curve analyses were conducted.Results: Two hundred and nineteen consecutive esophageal cancer patients were included in the study.The prevalence rates of severe malnutrition as determined by the ESPEN 2015 criteria, MUST, NRS 2002, and MNA-SF were 24.7%, 29.7%, 23.7%, and 16.0%, respectively. The moderate/severe malnutrition risk screened by the MUST had a high sensitivity (100.0%) with malnutrition identified by the ESPEN 2015 criteria. In total, 42 (19.2%) patients experienced major complications, and the incidence rate of EOF failure was 7.3%. The severe malnutrition identified by the ESPEN 2015 criteria, MUST, and NRS 2002 were comparable in predicting the incidence of postoperative pulmonary complications, anastomotic leakage, readmission to intensive care units (ICUs), and EOF failure, but the ESPEN 2015 criteria was better in predicting postoperative overall complications, major complications, and delayed hospital discharge. Conclusions:The ESPEN 2015 criteria specializes in identifying severe malnutrition and is better in predicting adverse surgical outcomes; however, the MUST and NRS 2002 are better superior in detecting early malnutrition and are also valuable in the perioperative management in esophageal surgery. It is recommended that the MUST be used as the malnutrition screening tool before the ESPEN 2015 criteria is applied.

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“…Uptake of nutritional supplementation during pulmonary rehabilitation improved quadriceps muscle strength, and inspiratory muscle function (88). Respiratory muscle rehabilitation, exercise, and enteral nutrition support increased MIP, MEP, and FVC (89).…”

Section: Combined Exercise and Nutritional Interventionmentioning

confidence: 94%

Respiratory Sarcopenia and Sarcopenic Respiratory Disability: Concepts, Diagnosis, and Treatment

Nagano

Wakabayashi

Maeda

et al. 2021

The Journal of nutrition, health and aging

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The condition of muscle fiber atrophy and weakness that occurs in respiratory muscles along with systemic skeletal muscle with age is known as respiratory sarcopenia. The Japanese Working Group of Respiratory Sarcopenia of the Japanese Association of Rehabilitation Nutrition narratively reviews these areas, and proposes the concept and diagnostic criteria. We have defined respiratory sarcopenia as "wholebody sarcopenia and low respiratory muscle mass followed by low respiratory muscle strength and/or low respiratory function." Respiratory sarcopenia can be caused by various factors such as aging, decreased activity, undernutrition, disease, cachexia, and iatrogenic causes. We have also created an algorithm for diagnosing respiratory sarcopenia. Respiratory function decreases with age in healthy older people, along with low respiratory muscle mass and strength. We have created a new term, "Presbypnea," meaning a decline in respiratory function with aging. Minor functional respiratory disability due to aging, such as that indicated by a modified Medical Research Council level 1 (troubled by shortness of breath when hurrying or walking straight up hill), is an indicator of presbypnea. We also define sarcopenic respiratory disability as "a disability with deteriorated respiratory function that results from respiratory sarcopenia." Sarcopenic respiratory disability is diagnosed if respiratory sarcopenia is present with functional disability. Cases of respiratory sarcopenia without functional disability are diagnosed as "at risk of sarcopenic respiratory disability." Functional disability is defined as a modified Medical Research Council grade of 2 or more. Rehabilitation nutrition, treatment that combines rehabilitation and nutritional management, may be adequate to prevent and treat respiratory sarcopenia and sarcopenic respiratory disability.

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Combination of preoperative pulmonary and nutritional preparation for esophagectomy

Cited by 6 publications

References 25 publications

Pre- and postoperative respiratory muscle strength, body mass index and fasting glucose profile of patients with type 2 diabetes mellitus submitted to metabolic surgery

Pre- and postoperative respiratory muscle strength, body mass index and fasting glucose profile of patients with type 2 diabetes mellitus submitted to metabolic surgery

Nutritional assessment in esophageal fast-track surgery: comparisons of 4 objective malnutrition screening tools

Respiratory Sarcopenia and Sarcopenic Respiratory Disability: Concepts, Diagnosis, and Treatment

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