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
. 2020 Nov;24(11):2667-2678.
doi: 10.1007/s11605-020-04696-2. Epub 2020 Jul 6.

Cardiopulmonary Exercise Testing in Oesophagogastric Surgery: a Systematic Review

G Sheill  1 , S Reynolds  2 , L O'Neill  2 , D Mockler  3 , J V Reynolds  4 , J Hussey  2 , E Guinan  5
Affiliations

Cardiopulmonary Exercise Testing in Oesophagogastric Surgery: a Systematic Review

G Sheill et al. J Gastrointest Surg. 2020 Nov.

Abstract

Background: Cardiopulmonary exercise testing (CPX) can objectively measure fitness and oxygen uptake at anaerobic threshold. The relationship between fitness and postoperative outcomes after upper gastro-intestinal surgery is unclear. The aim of the present review is to assess the prognostic ability of CPX in predicting postoperative outcome associated with oesophagogastric surgery.

Methods: Relevant studies were identified through a systematic search of EMBASE, Medline, CINAHL, Cochrane Library, and Web of Science to July 2019. The eligibility criteria for studies included prognostic studies of upper gastro-intestinal surgery among adult populations using a preoperative CPX and measurement of postoperative outcome (mortality or morbidity or length of stay). Risk of bias was assessed using the QUIPS Quality in Prognostic Studies validated tool.

Results: Thirteen papers with a total of 1735 participants were included in data extraction. A total of 7 studies examined the association between CPX variables and postoperative mortality. Patients undergoing gastro-intestinal surgery with lower anaerobic threshold values were found to have an increased risk of postoperative mortality. Similarly, a lower rate of oxygen consumption was found to be associated with higher mortality. There was conflicting evidence regarding the association between CPX variables and postoperative morbidity. The evidence did not demonstrate any association between preoperative CPX variables and hospital length of stay.

Conclusion: Studies report an association between CPX variables and postoperative mortality; however, there is conflicting evidence regarding the association between CPX variables and postoperative morbidity.

Keywords: Cardiopulmonary exercise testing; Exercise test; Perioperative medicine.

PubMed Disclaimer

References

    1. Kelly, R.J., Emerging Multimodality Approaches to Treat Localized Esophageal Cancer. Journal of the National Comprehensive Cancer Network, 2019. 17(8): p. 1009-1014.
    1. D’Amico, T.A., Outcomes after surgery for esophageal cancer. Gastrointestinal cancer research: GCR, 2007. 1(5): p. 188.
    1. Pasquer, A., et al., Is centralization needed for esophageal and gastric cancer patients with low operative risk? Annals of surgery, 2016. 264(5): p. 823-830.
    1. Atkins, B.Z., et al., Reducing hospital morbidity and mortality following esophagectomy. The Annals of thoracic surgery, 2004. 78(4): p. 1170-1176.
    1. Linden, P.A., et al., Mortality After Esophagectomy: Analysis of Individual Complications and Their Association with Mortality. Journal of Gastrointestinal Surgery, 2019.

Publication types

LinkOut - more resources