Application of exercised-based pre-rehabilitation in perioperative period of patients with gastric cancer

Wu, Jianjun; Wu, Xing; Yao, Guozhong; Zhu, Changtai; Jiang, Yan

doi:10.1515/med-2019-0103

Cited by 9 publications

(5 citation statements)

References 24 publications

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“…52 In addition, preoperative rehabilitation (pre-rehabilitation) before upper abdominal surgery may help improve respiratory muscle strength. [53][54][55] We identified a poor OS in patients who underwent total gastrectomy, which is consistent with previous studies. [56][57][58] Fig.…”

Section: Discussionsupporting

confidence: 91%

Significance of Preoperative Pulmonary Function on Short- and Long-Term Outcomes Following Gastrectomy for Gastric Cancer

Sekimoto

Miyake

Nagai

et al. 2023

Journal of Gastrointestinal Surgery

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Background Preoperative pulmonary function assessment is useful for selecting surgical candidates and operative methods and assessing the risk of postoperative pulmonary complications. However, few studies have investigated the relationship between preoperative pulmonary function and short-and long-term outcomes in patients who underwent gastrectomy for gastric cancer. Methods Of the 1040 patients with gastric cancer (stages I-III) who had undergone R0 gastrectomy between 2009 and 2020, 750 who underwent preoperative spirometry were included. Restrictive ventilatory impairment was defined as a vital capacity of the predicted value (%VC) < 80%, while obstructive ventilatory impairment was defined as forced expiratory volume in one second (FEV1%) < 70%. Postoperative complications were assessed using the Clavien-Dindo (CD) classification. The relationship between clinical factors, including %VC, FEV1%, severe postoperative complications (CD ≥ 3b), overall survival (OS), and relapse-free survival, were assessed. ResultsThe mean age of the 750 patients was 68 ± 10.5 years. Severe postoperative complications were observed in 25 (3.3%) patients and were significantly associated with FEV1% < 70% in the univariate analysis. The 5-year OS was 72.5%. Multivariate analysis showed that the cancer stage, age > 75 years, preoperative comorbidities, %VC < 80%, total gastrectomy, severe postoperative complications, and postoperative adjuvant chemotherapy were the significant independent factors affecting OS. Pneumonia was significantly associated with %VC < 80%. Conclusions FEV1% < 70%was associated with the development of severe postoperative complications, while %VC < 80% was associated with poor OS independent of the cancer stage because of death from pneumonia. Spirometry helps surgeons and patients discuss the risks and benefits of surgery.

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Section: Discussionsupporting

confidence: 91%

Significance of Preoperative Pulmonary Function on Short- and Long-Term Outcomes Following Gastrectomy for Gastric Cancer

Sekimoto

Miyake

Nagai

et al. 2023

Journal of Gastrointestinal Surgery

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“…2,[46][47][48][49][50][51][52][53] For the studies assessing periand postoperative physiotherapy, there were six RCTs [54][55][56][57][58][59] comparing an intervention with a control group, and one study 60 compared two different types of physiotherapy. Among the cohort studies, eight studies [61][62][63][64][65][66][67][68] S5. Finally, six RCTs 38,[40][41][42][43][44] and eight cohort studies 2,46-49,51-53 assessing prehabilitation, and five RCTs [54][55][56]58,59 and five cohort studies 61,62,65,67,68 S6 for each analysis.…”

Section: Literature Search Resultsmentioning

confidence: 99%

“…Among the cohort studies, eight studies [61][62][63][64][65][66][67][68] S5. Finally, six RCTs 38,[40][41][42][43][44] and eight cohort studies 2,46-49,51-53 assessing prehabilitation, and five RCTs [54][55][56]58,59 and five cohort studies 61,62,65,67,68 S6 for each analysis.…”

Section: Literature Search Resultsmentioning

confidence: 99%

Physiotherapy Regimens in Esophagectomy and Gastrectomy: a Systematic Review and Meta-Analysis

et al. 2021

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Background Esophageal and gastric cancer surgery are associated with considerable morbidity, specifically postoperative pulmonary complications (PPCs), potentially accentuated by underlying challenges with malnutrition and cachexia affecting respiratory muscle mass. Physiotherapy regimens aim to increase the respiratory muscle strength and may prevent postoperative morbidity. Objective The aim of this study was to assess the impact of physiotherapy regimens in patients treated with esophagectomy or gastrectomy. Methods An electronic database search was performed in the MEDLINE, EMBASE, CENTRAL, CINAHL and Pedro databases. A meta-analysis was performed to assess the impact of physiotherapy on the functional capacity, incidence of PPCs and postoperative morbidity, in-hospital mortality rate, length of hospital stay (LOS) and health-related quality of life (HRQoL). Results Seven randomized controlled trials (RCTs) and seven cohort studies assessing prehabilitation totaling 960 patients, and five RCTs and five cohort studies assessing peri- or postoperative physiotherapy with 703 total patients, were included. Prehabilitation resulted in a lower incidence of postoperative pneumonia and morbidity (Clavien–Dindo score ≥ II). No difference was observed in functional exercise capacity and in-hospital mortality following prehabilitation. Meanwhile, peri- or postoperative rehabilitation resulted in a lower incidence of pneumonia, shorter LOS, and better HRQoL scores for dyspnea and physical functioning, while no differences were found for the QoL summary score, global health status, fatigue, and pain scores. Conclusion This meta-analysis suggests that implementing an exercise intervention may be beneficial in both the preoperative and peri- or postoperative periods. Further investigation is needed to understand the mechanism through which exercise interventions improve clinical outcomes and which patient subgroup will gain the maximal benefit.

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“…Triple-modal pre-rehabilitation strategies consist of exercise, nutrition support, and psychological intervention. This strategy is useful for the preservation and recovery of organ function [11][12][13]. Several studies have reported that the use of triple-modal pre-rehabilitation strategies is more effective than the single pre-rehabilitation strategy [14,15].…”

Section: Introductionmentioning

confidence: 99%

Retrospective analysis of preoperative application of triple-modal pre-rehabilitation on postoperative recovery of colorectal cancer patients

Huang,

Xiao,

Wang

et al. 2024

Support Care Cancer

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To retrospectively analyze the difference between triple-modal pre-rehabilitation and common treatment in patients with colorectal cancer (CRC). MethodsA total of 145 patients with CRC diagnosed by pathology and admitted to our hospital for surgery between June 2020 and June 2022 were included in the study. All patients were divided into two groups: the triple-modal pre-rehabilitation group (pre-rehabilitation group) and the common treatment group. The triple-modal pre-rehabilitation strategy included exercise (3-5 times per week, with each session lasting more than 50 min), nutritional support and psychological support. The study was designed to assess the potential of the pre-rehabilitation intervention to accelerate postoperative recovery by assessing the 6minute walk test, nutritional indicators and HADS score before and after surgery. ResultsThe pre-rehabilitation intervention did not reduce the duration of initial postoperative recovery or the incidence of postoperative complications, but it did increase the patients' exercise capacity (as determined by the 6-minute walk test), with the pre-rehabilitation group performing signi cantly better than the common group (433.0 [105.0] vs. 389.0 [103.5], P < 0.001). The study also found that triplemodal pre-rehabilitation was bene cial for the early recovery of nutritional status in surgical patients and improved anxiety and depression in patients after surgery, especially in those who had not received neoadjuvant therapy. ConclusionThe triple-modal pre-rehabilitation strategy is of signi cant importance for reducing stress and improving the functional reserve of patients with colorectal cancer (CRC) during the perioperative period. The results of our study provide further support for the integration of the triple-modal pre-rehabilitation strategy into the treatment and care of CRC patients.

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Application of exercised-based pre-rehabilitation in perioperative period of patients with gastric cancer

Abstract: AbstractObjectiveTo analyze the difference between exercised-based pre-rehabilitation and postoperative rapid rehabilitation of gastric cancer patients.MethodsThe clinical data of 120 patients who underwent surgical treatment between 2016 and 2018 in our hospital with pat… Show more

Cited by 9 publications

References 24 publications

Significance of Preoperative Pulmonary Function on Short- and Long-Term Outcomes Following Gastrectomy for Gastric Cancer

Significance of Preoperative Pulmonary Function on Short- and Long-Term Outcomes Following Gastrectomy for Gastric Cancer

Physiotherapy Regimens in Esophagectomy and Gastrectomy: a Systematic Review and Meta-Analysis

Retrospective analysis of preoperative application of triple-modal pre-rehabilitation on postoperative recovery of colorectal cancer patients

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