Prevention of postoperative pulmonary complications through intensive preoperative respiratory rehabilitation in patients with esophageal cancer

Inoue, Jun–ichiro; Ono, Rei; Makiura, Daisuke; Kashiwa-Motoyama, Miyuki; Miura, Yasushi; Usami, M.; Nakamura, Tetsu; Imanishi, Tatsuya; Kuroda, Daisuke

doi:10.1111/j.1442-2050.2012.01336.x

Cited by 97 publications

(80 citation statements)

References 40 publications

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“…Pre-operative exercise for lung cancer patients was associated with a number of benefits for patients [32]. Prehabilitative versus rehabilitative swallowing or respiratory therapy led to significant benefits for patients with head and neck cancers [33][34][35]. There appears to be a potentially significant advantage to implementing prehabilitation rather than rehabilitation interventions for cancer patients.…”

Section: Discussionmentioning

confidence: 99%

An international review and meta-analysis of prehabilitation compared to usual care for cancer patients

2017

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Purpose The purpose of the study is to systematically review and synthesise randomised controlled trials investigating the effectiveness of prehabilitation compared to usual care for newly diagnosed, adult-onset cancer patients. Methods MEDLINE, EMBASE, PsycINFO, CINAHL and SSCI were searched up to April 2017. Studies were included if disease-related, treatment-related, patient-reported and health service utilisation outcomes were assessed. Two reviewers independently reviewed and appraised the risk of bias of each study. Results Eighteen studies were included. Interventions comprised one or more of the following components: psychological support, education and exercise. Meta-analyses found that pelvic floor muscle training (PFMT) significantly increased odds of continence at 3 months (OR = 3.29, 95% CI = 1.57-6.91), but did not significantly reduce daily pad use at 6 months post-surgery Mean Difference (MD)= ( = − 0.96, 95% CI = − 2.04-0.12) for prostate cancer patients. Although quality of life improved due to PFMT, functional ability or distress did not. Further meta-analyses indicated that presurgical exercise significantly reduced length of hospital stay (MD = − 4.18, 95% CI = − 5.43-− 2.93) and significantly lowered odds of post-surgery complications (OR = 0.25, 95% CI = 0.10-0.66) for lung cancer patients. Psychology-based prehabilitation significantly improved mood, physical wellbeing and immune function for prostate cancer patients and improved fatigue and psychological outcomes and a trend for better quality of life among breast cancer patients. Risk of bias was high for most studies. Conclusions Prehabilitation appears to benefit cancer patients. Rigorous trials are needed to investigate the effectiveness of prehabilitation among other cancer sites and other related effects. The cost-effectiveness of prehabilitation remains unanswered. Implications for cancer survivors Providing interventions earlier in the care pathway may lead to better outcomes for patients during survivorship.

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Section: Discussionmentioning

confidence: 99%

An international review and meta-analysis of prehabilitation compared to usual care for cancer patients

2017

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“…Only one retrospective study has been reported [22] . In this previously reported study, 100 patients who underwent esophagectomy were retrospectively analyzed.…”

Section: Discussionmentioning

confidence: 99%

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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“…Sometimes it is warranted to delay surgery to supplement proteins as this might improve wound healing and prevent infections or anastomotic breakdown. Early involvement of physiotherapist to improve physical or cardiopulmonary fitness and a dietician for a good nutritional state seems rational but studies into the effect on outcome are contradictory (14)(15)(16)(17).…”

Section: Preoperative Screening and Optimisationmentioning

confidence: 99%

Anaesthesia during oesophagectomy

Veelo

Geerts

2017

J. Thorac. Dis.

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Prevention of postoperative pulmonary complications through intensive preoperative respiratory rehabilitation in patients with esophageal cancer

Cited by 97 publications

References 40 publications

An international review and meta-analysis of prehabilitation compared to usual care for cancer patients

An international review and meta-analysis of prehabilitation compared to usual care for cancer patients

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

Anaesthesia during oesophagectomy

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