Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Jan;18(1):56-64.
doi: 10.1007/s10388-020-00757-2. Epub 2020 Jul 1.

Efficacy of enhanced prehabilitation for patients with esophageal cancer undergoing esophagectomy

Yuji Akiyama  1 , Akira Sasaki  2 , Yusuke Fujii  3 , Ryosuke Fujisawa  2 , Noriyuki Sasaki  2 , Haruka Nikai  2 , Fumitaka Endo  2 , Shigeaki Baba  2 , Yasushi Hasegawa  2 , Toshimoto Kimura  2 , Takeshi Takahara  2 , Hiroyuki Nitta  2 , Koki Otsuka  2 , Keisuke Koeda  4 , Yukihide Nishimura  3 , Takeshi Iwaya  2
Affiliations

Efficacy of enhanced prehabilitation for patients with esophageal cancer undergoing esophagectomy

Yuji Akiyama et al. Esophagus. 2021 Jan.

Abstract

Background: Several studies have demonstrated that prehabilitation helps reduce the incidence of postoperative complications. In this study, we investigated the safety and efficacy of enhanced prehabilitation (EP) in the hospital for patients with esophageal cancer.

Methods: We retrospectively reviewed the data of 48 consecutive patients who underwent radical esophagectomy with gastric tube reconstruction between September 2015 and June 2019. EP program had been introduced in August 2017. In the EP group, patients received the EP program during hospitalization 7 days before surgery in addition to conventional perioperative rehabilitation. The EP program consisted of aerobic exercise and muscle strength training in the morning and afternoon. Operative outcomes were compared between patients who received EP (EP group; 23 patients) and patients who did not receive EP (control group; 25 patients).

Results: The preoperative (EP group vs. control group, 492.9 ± 79.7 vs. 418.9 ± 71.8 m, p < 0.001) and postoperative (EP group vs. control group, 431.5 ± 80 vs. 378 ± 68.7 m, p < 0.001) 6-min walk distance was significantly higher in the EP group than in the control group. The respiratory complications rate was significantly lower in the EP group (4.3%) than in the control group (36%) (p = 0.007). The incidence of atelectasis was particularly significantly lower in the EP group (0%) than in the control group (24%) (p = 0.012).

Conclusions: EP was performed safely for patients before esophagectomy. EP improved the exercise tolerance of the patients before esophagectomy and might be useful in preventing respiratory complications.

Keywords: Esophageal squamous cell carcinoma; Esophagectomy; Exercise tolerance.

PubMed Disclaimer

References

    1. Low DE, Alderson D, Cecconello I, et al. International consensus on standardization of data collection for complications associated with esophagectomy: Esophagectomy Complications Consensus Group (ECCG). Ann Surg. 2015;262:286–94. - DOI
    1. Takeuchi H, Miyata H, Gotoh M, et al. A risk model for esophagectomy using data of 5354 patients included in a Japanese nationwide web-based database. Ann Surg. 2014;260:259–66. - DOI
    1. Markar S, Gronnier C, Duhamel A, et al. Pattern of postoperative mortality after esophageal cancer resection according to center volume: Results from a large european multicenter study. Ann Surg Oncol. 2015;22:2615–23. - DOI
    1. Baba Y, Yoshida N, Shigaki H, et al. Prognostic Impact of Postoperative complications in 502 patients with surgically resected esophageal squamous cell carcinoma: a retrospective single-institution study. Ann Surg. 2016;264:305–11. - DOI
    1. Akiyama Y, Iwaya T, Endo F, et al. Effectiveness of intervention with a perioperative multidisciplinary support team for radical esophagectomy. Support Care Cancer. 2017;25:3733–9. - DOI

MeSH terms

LinkOut - more resources