Long-Term Trends in Respiratory Function After Esophagectomy for Esophageal Cancer

Ichikawa, Hiroshi; Hanyu, Takaaki; Ishikawa, Takashi; Kano, Yosuke; Kanda, Tatsuo; Kosugi, Shin‐ichi; Wakai, Toshifumi

doi:10.1016/j.jss.2019.07.040

Cited by 10 publications

(11 citation statements)

References 23 publications

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“…Results of the 6MWD test at the 3-month follow-up demonstrated physical status comparable to that at baseline, indicating the effects of the CIMmH with regard to buffering the deterioration of physical fitness in patients after esophagectomy. Previous studies involving traditional postoperative rehabilitation showed a greater decrease in the 6MWD in the third month after surgery when compared with the finding in this study [ 51 , 52 ]. Lastly, with respect to psychological outcomes, depressive symptoms greatly increased at the 1-month follow-up, while anxiety and stress did not change greatly across all time points.…”

Section: Discussionsupporting

confidence: 52%

Development and Feasibility of a Mobile Health–Supported Comprehensive Intervention Model (CIMmH) for Improving the Quality of Life of Patients With Esophageal Cancer After Esophagectomy: Prospective, Single-Arm, Nonrandomized Pilot Study

Cheng¹,

Ho²,

Guo³

et al. 2020

J Med Internet Res

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Background Patients with esophageal cancer often experience clinically relevant deterioration of quality of life (QOL) after esophagectomy owing to malnutrition, lack of physical exercise, and psychological symptoms. Objective This study aimed to evaluate the feasibility, safety, and efficacy of a comprehensive intervention model using a mobile health system (CIMmH) in patients with esophageal cancer after esophagectomy. Methods Twenty patients with esophageal cancer undergoing the modified McKeown surgical procedure were invited to join the CIMmH program with both online and offline components for 12 weeks. The participants were assessed before surgery and again at 1 and 3 months after esophagectomy. QOL, depressive symptoms, anxiety, stress, nutrition, and physical fitness were measured. Results Of the 20 patients, 16 (80%) completed the program. One month after esophagectomy, patients showed significant deterioration in overall QOL (P=.02), eating (P=.005), reflux (P=.04), and trouble with talking (P<.001). At the 3-month follow-up, except for pain (P=.02), difficulty with eating (P=.03), dry mouth (P=.04), and trouble with talking (P=.003), all other QOL dimensions returned to the preoperative level. There were significant reductions in weight (P<.001) and BMI (P=.02) throughout the study, and no significant changes were observed for physical fitness measured by change in the 6-minute walk distance between baseline and the 1-month follow-up (P=.22) or between baseline and the 3-month follow-up (P=.52). Depressive symptoms significantly increased 1 month after surgery (P<.001), while other psychological measures did not show relevant changes. Although there were declines in many measures 1 month after surgery, these were much improved at the 3-month follow-up, and the recovery was more profound and faster than with traditional rehabilitation programs. Conclusions The CIMmH was feasible and safe and demonstrated encouraging efficacy testing with a control group for enhancing recovery after surgery among patients with esophageal cancer in China. Trial Registration Chinese Clinical Trial Registry (ChiCTR-IPR-1800019900); http://www.chictr.org.cn/showprojen.aspx?proj=32811.

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Section: Discussionsupporting

confidence: 52%

Development and Feasibility of a Mobile Health–Supported Comprehensive Intervention Model (CIMmH) for Improving the Quality of Life of Patients With Esophageal Cancer After Esophagectomy: Prospective, Single-Arm, Nonrandomized Pilot Study

Cheng¹,

Ho²,

Guo³

et al. 2020

J Med Internet Res

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“…In the study at hand, this issue could also not be addressed satisfactorily, as there were only three patients in which a minimally invasive approach was performed. Previous studies, which focused on surgery requiring thoracotomy but did not involve lung resection have shown a relevant lung function decline (20)(21)(22).…”

Section: Discussionmentioning

confidence: 99%

Surgical Morbidity and Lung Function Changes After Laser–Assisted Pulmonary Metastasectomy: A Prospective Bicentric Study

et al. 2021

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Objective: The surgical resection of pulmonary metastases is associated with a survival benefit in selected patients. The use of laser devices for pulmonary metastasectomy (PM) is believed to facilitate the complete resection of metastases while preserving a maximum of healthy parenchyma. This is a prospective study to evaluate surgical outcome including the changes of lung function after laser–assisted surgery (LAS).Methods: A total of 77 operations in 61 patients in which PM was carried out in a curative intent were analyzed. A 1.320 nm diode-pumped Nd: YAG-Laser was used for resection of the metastases. Surgical and clinical data were collected using a standardized form and postoperative lung function changes 3 and 6 months after surgery were assessed using whole body plethysmography and diffusion capacity for carbon monoxide (DLCO). Size and distance of metastases to the pleural surface were measured radiologically.Results: A median of two metastases were resected per operation (range 1–13). The median duration of postoperative air leak was 1 day (range 0–11). LAS associated postoperative minor and major complications were observed in 4 (5%) cases and 1 (1%) case, respectively; there were no mortalities. The analysis of perioperative lung function showed that mean VC 3 months after surgery was reduced by 11 %, FEV1 by 11% and median DLCO by 11% (all p < 0.0001). There was almost no recovery of lung function between 3 and 6 months in the whole cohort. Patients with two or less metastases showed a recovery of lung function after 3 months regarding DLCO (p = 0.003). Decline of DLCO in the whole cohort correlated with the number of resected metastases at 3 months (r = 0.45, p = 0.006) and at 6 months (r = 0.42, p = 0.02) as well as depth of metastases in the parenchyma at 6 months (r = 0.48, p = 0.001).Conclusions: LAS is a safe and effective method for PM even for higher numbers of metastases, with short duration of postoperative air leak and little morbidity. Number and depth, but not size of metastases affect lung function changes after resection.

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“…However, this conclusion have to be drawn with some caution. Only two studies were included in this analysis, both using a 6MWT to measure functional exercise capacity [35,36]. The 6MWT seems to be a valid measure to assess functional exercise capacity in patients with cancer [53].…”

Section: Discussionmentioning

confidence: 99%

“…Studies with an exercise intervention showed a restore in exercise capacity (SMD 0.13 (À0.25; 0.51), p ¼ .50, I 2 ¼ 0%) [34,37], and studies without an exercise intervention showed a decrease in exercise capacity (SMD -0.51 (À0.73; À0.29), p < .01, I 2 ¼ 39%) [27,35,36,42]. The difference between subgroups was significant (p < .01).…”

Section: Impact Of Esophagectomymentioning

confidence: 99%

Impact of curative treatment on the physical fitness of patients with esophageal cancer: A systematic review and meta-analysis

Reijneveld

Bor

Dronkers

et al. 2022

European Journal of Surgical Oncology

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Background: Esophageal cancer and curative treatment have a significant impact on the physical fitness of patients. Knowledge about the course of physical fitness during neoadjuvant therapy and esophagectomy is helpful to determine the needs for interventions during and after curative treatment. This study aims to review the current evidence on the impact of curative treatment on the physical fitness of patients with esophageal cancer. Methods: A systematic literature search of PubMed, Embase, Cinahl and the Cochrane Library was conducted up to March 29, 2021. We included observational studies investigating the change of physical fitness (including exercise capacity, muscle strength, physical activity and activities of daily living) from pre-to post-neoadjuvant therapy and/or from pre-to post-esophagectomy. Quality of the studies was assessed and a meta-analysis was performed using standardized mean differences. Results: Twenty-seven articles were included. After neoadjuvant therapy, physical fitness decreased significantly. In the first three months after surgery, physical fitness was also significantly decreased compared to preoperative values. Subgroup analysis showed a restore in exercise capacity three months after surgery in patients who followed an exercise program. Six months after surgery, there was limited evidence that exercise capacity restored to preoperative values. Conclusion: Curative treatment seems to result in a decrease of physical fitness in patients with esophageal cancer, up to three months postoperatively. Six months postoperatively, results were conflicting. In patients who followed a pre-or postoperative exercise program, the postoperative impact of curative treatment seems to be less.

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Long-Term Trends in Respiratory Function After Esophagectomy for Esophageal Cancer

Cited by 10 publications

References 23 publications

Development and Feasibility of a Mobile Health–Supported Comprehensive Intervention Model (CIMmH) for Improving the Quality of Life of Patients With Esophageal Cancer After Esophagectomy: Prospective, Single-Arm, Nonrandomized Pilot Study

Development and Feasibility of a Mobile Health–Supported Comprehensive Intervention Model (CIMmH) for Improving the Quality of Life of Patients With Esophageal Cancer After Esophagectomy: Prospective, Single-Arm, Nonrandomized Pilot Study

Surgical Morbidity and Lung Function Changes After Laser–Assisted Pulmonary Metastasectomy: A Prospective Bicentric Study

Impact of curative treatment on the physical fitness of patients with esophageal cancer: A systematic review and meta-analysis

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