Preoperative inspiratory muscle weakness as a risk factor of postoperative pulmonary complications in patients with esophageal cancer

Okura, Kazuki; Suto, Akiyoshi; Sato, Yusuke; Takahashi, Yusuke; Hatakeyama, Kazutoshi; Nagaki, Yushi; Wakita, Akiyuki; Kasukawa, Yuji; Miyakoshi, Naohisa; Minamiya, Yoshihiro

doi:10.1002/jso.27436

Cited by 7 publications

References 33 publications

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Definition, diagnosis, and treatment of respiratory sarcopenia

Miyazaki,

Tamaki,

Wakabayashi

et al. 2023

Current Opinion in Clinical Nutrition &Amp; Metabolic Care

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Purpose of review Skeletal muscle weakness and wasting also occurs in the respiratory muscles, called respiratory sarcopenia. Respiratory sarcopenia may lead to worse clinical indicators and outcomes. We present a novel definition and diagnostic criteria for respiratory sarcopenia, summarize recent reports on the association between respiratory sarcopenia, physical and nutritional status, and clinical outcomes, and provide suggestions for the prevention and treatment of respiratory sarcopenia. Recent findings Recently, a novel definition and diagnostic criteria for respiratory sarcopenia have been prepared. Respiratory sarcopenia is defined as a condition in which there is both low respiratory muscle strength and low respiratory muscle mass. Respiratory muscle strength, respiratory muscle mass, and appendicular skeletal muscle mass are used to diagnose respiratory sarcopenia. Currently, it is challenging to definitively diagnose respiratory sarcopenia due to the difficulty in accurately determining low respiratory muscle mass. Decreased respiratory muscle strength and respiratory muscle mass are associated with lower physical and nutritional status and poorer clinical outcomes. Exercise interventions, especially respiratory muscle training, nutritional interventions, and their combinations may effectively treat respiratory sarcopenia. Preventive interventions for respiratory sarcopenia are unclear. Summary The novel definition and diagnostic criteria will contribute to promoting the assessment and intervention of respiratory sarcopenia.

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Definition, diagnosis, and treatment of respiratory sarcopenia

Miyazaki,

Tamaki,

Wakabayashi

et al. 2023

Current Opinion in Clinical Nutrition &Amp; Metabolic Care

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Tongue pressure, respiratory muscle and limb strength and functional exercise capacity in oesophageal cancer

Fukushima,

Yamasaki,

Yamamoto

et al. 2024

BMJ Support Palliat Care

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ObjectivesPreoperative management of oesophageal cancer requires effective prehabilitation. This study investigates the relationship between tongue pressure, respiratory muscle, handgrip and lower limb muscle strengths, and functional exercise capacity in patients with oesophageal cancer to develop a novel prehabilitation strategy.MethodsThis prospective, single-centre, observational study analysed data from 29 pretreatment patients with oesophageal cancer. We evaluated tongue pressure, maximal inspiratory and expiratory pressures, handgrip and lower limb muscle strengths, functional exercise capacity and dysphagia scores before treatment. The relationship between parameters was identified using Spearman’s correlation analysis.ResultsMaximal inspiratory and expiratory pressures were significantly associated with handgrip and lower extremity muscle strengths and functional exercise capacity. However, tongue pressure was not associated with maximal inspiratory and expiratory pressures, handgrip and lower extremity muscle strengths and functional exercise capacity. Rather, tongue pressure was significantly associated with clinical T, dysphagia and nutritional status scores.ConclusionsRespiratory muscle strength was associated with conventional sarcopenia and functional exercise capacity. Tongue pressure was not associated with respiratory muscle strength, conventional sarcopenia and functional exercise capacity. Rather, tongue pressure was associated with clinical T, dysphagia and nutritional status scores. Preoperative management of oesophageal cancer requires prehabilitation consisting of exercise and nutritional therapy and an additional swallowing programme, such as tongue resistance training, for patients without progress in oral intake, based on tongue pressure evaluation.

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