Pre-operative dental brushing can reduce the risk of postoperative pneumonia in esophageal cancer patients

Akutsu, Yasunori; Matsubara, Hisahiro; Shuto, Kiyohiko; Shiratori, Toru; Uesato, Masaya; Miyazawa, Yasumasa; Hoshino, Isamu; Murakami, Kentaro; Usui, Akihiro; Kano, Masayuki; Miyauchi, Hideaki

doi:10.1016/j.surg.2009.10.048

Cited by 127 publications

(77 citation statements)

References 23 publications

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“…Another study suggested that perioperative steroid therapy was effective for inhibiting the release of inflammatory mediators, such as interleukin (IL)-6 and IL-8, and decreasing the rate of postoperative pulmonary complications after esophageal cancer surgery [20] . It was also reported that pathogens present in preoperative dental plaque are risk factors for postoperative pneumonia following esophagectomy [21] . However, in this study, the rate of video-assisted thoracic surgery was not significantly different between the two groups.…”

Section: Discussionmentioning

confidence: 98%

Randomized Controlled Study to Evaluate the Efficacy of a Preoperative Respiratory Rehabilitation Program to Prevent Postoperative Pulmonary Complications after Esophagectomy

et al. 2015

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Background/Aims: Patients with postoperative pulmonary complications after esophagectomy often have increased mortality. The purpose of the study was to examine the efficacy of preventing postoperative pulmonary complications by an intensive preoperative respiratory rehabilitation (PR) program for esophageal cancer patients. Methods: This study was a prospective randomized controlled study. Thirty patients in the PR group and 30 patients in the no preoperative respiratory rehabilitation (NPR) group were included. The PR group received preoperative rehabilitation for more than 7 days, while the NPR group did not receive any preoperative rehabilitation. All patients underwent postoperative rehabilitation from the first postoperative day. The postoperative pulmonary complications were evaluated using the Clavien-Dindo classification (CDC) and the Utrecht Pneumonia Scoring System (UPSS). Results: The CDC grade in the PR group was significantly lower than that in the NPR group (p = 0.014). The UPSS score in the PR group was significantly lower than that in the NPR group at postoperative day 1 (p = 0.031). In the multivariate analysis, NPR was an independent risk factor for postoperative pulmonary complications greater than CDC grade II (OR: 3.99, 95% CI: 1.28-12.4, p = 0.017). Conclusions: This study showed that the intensive PR program was capable of reducing the postoperative pulmonary complications in esophageal cancer patients.

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Section: Discussionmentioning

confidence: 98%

Randomized Controlled Study to Evaluate the Efficacy of a Preoperative Respiratory Rehabilitation Program to Prevent Postoperative Pulmonary Complications after Esophagectomy

et al. 2015

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“…Second, this study revealed pneumonia to be the most common complication that could cause a worsening of the outcome for elderly patients. Although dysphagia during or after CRT is a well-known issue (Nguyen et al 2004), appropriate supportive care, such as dental brushing, might be needed for CRT patients as well as for surgical patients (Akutsu et al 2010).…”

Section: Discussionmentioning

confidence: 99%

Surgical Treatment Is Recommended for Advanced Oral Squamous Cell Carcinoma

Ogawa

Matsuura

Shiga

et al. 2011

Tohoku J. Exp. Med.

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Oral squamous cell carcinoma is one of the most frequent types of head and neck cancers in Japan. Although recent reports have shown positive results of non-surgical treatment for advanced head and neck squamous cell carcinoma, including tongue cancer, no clear treatment strategies have been established for oral cancers, except for tongue cancer. To assess appropriate therapies, we conducted a retrospective chart review of 114 Japanese patients with oral cancers that were pathologically diagnosed as squamous cell carcinoma, excluding tongue cancers. The overall and the disease specific 5-year survival rates were 53% and 61%, respectively. Univariate and multivariate analyses revealed a lower stage (I, II, or III) and non-surgical treatment as good and poor prognostic factors of oral squamous cell carcinoma, respectively, based on their hazard ratios of 0.17 (95% CI 0.045-0.60, p = 0.0061) and 5.3 (95% CI 2.7-11, p < 0.0001). Furthermore, impact of surgery was well documented in the operable stage IVa cancers (p = 0.00015). The surgical treatment consisted of the wide resection of the primary tumor and the neck dissection for stage III or IV tumors. The present data also suggest that adjunctive therapy, such as post-operative radiation therapy or post-operative chemo-radiation therapy, shows no survival benefit compared to the surgery alone. We therefore recommend the surgical treatment for advanced oral squamous cell carcinoma in Japanese patients. These results would be helpful in future clinical trials, especially in non-surgical treatment studies of oral squamous cell carcinoma in Japan.

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“…In a cohort of patients with esophageal cancer, a protocol of brushing teeth 6 times daily resulted in a significant reduction in the incidence of postoperative pneumonia. 30 It remains uncertain, however, whether such an approach could reduce the rate of VAp in surgical patients. Bergan et al 31 tried to reduce the rate of postoperative pneumonia in cardiac surgery patients by implementing a care bundle focused on optimizing oral health before surgery.…”

Section: Ventilation and Sedationmentioning

confidence: 99%

Recent Advances in Multidisciplinary Critical Care

Blot

Afonso

Labeau

2015

American Journal of Critical Care

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The intensive care unit is a work environment where superior dedication is crucial for optimizing patients' outcomes. As this demanding commitment is multidisciplinary in nature, it requires special qualities of health care workers and organizations. Thus research in the field covers a broad spectrum of activities necessary to deliver cutting-edge care. However, given the numerous research articles and education activities available, it is difficult for modern critical care clinicians to keep up with the latest progress and innovation in the field. This article broadly summarizes new developments in multidisciplinary intensive care. It provides elementary information about advanced insights in the field via brief descriptions of selected articles grouped by specific topics. Issues considered include care for heart patients, mechanical ventilation, delirium, nutrition, pressure ulcers, early mobility, infection prevention, transplantation and organ donation, care for caregivers, and family matters.

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Pre-operative dental brushing can reduce the risk of postoperative pneumonia in esophageal cancer patients

Cited by 127 publications

References 23 publications

Randomized Controlled Study to Evaluate the Efficacy of a Preoperative Respiratory Rehabilitation Program to Prevent Postoperative Pulmonary Complications after Esophagectomy

Randomized Controlled Study to Evaluate the Efficacy of a Preoperative Respiratory Rehabilitation Program to Prevent Postoperative Pulmonary Complications after Esophagectomy

Surgical Treatment Is Recommended for Advanced Oral Squamous Cell Carcinoma

Recent Advances in Multidisciplinary Critical Care

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