Clinical benefits of a swallowing intervention for esophageal cancer patients after esophagectomy

2020 ◽  
Author(s):  
Jun Takatsu ◽  
Eiji Higaki ◽  
Takahiro Hosoi ◽  
Masahiro Yoshida ◽  
Masahiko Yamamoto ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Cancer Patients ◽  
Enhanced Recovery ◽  
Intervention Group ◽  
Oral Intake ◽  
Control Group ◽  
Recurrent Laryngeal Nerve Paralysis ◽  
Swallowing Function ◽  
Nerve Paralysis ◽  
Postoperative Stay

Summary Dysphagia after esophagectomy is the main cause of a prolonged postoperative stay. The present study investigated the effects of a swallowing intervention led by a speech–language–hearing therapist (SLHT) on postoperative dysphagia. We enrolled 276 consecutive esophageal cancer patients who underwent esophagectomy and cervical esophagogastric anastomosis between July 2015 and December 2018; 109 received standard care (control group) and 167 were treated by a swallowing intervention (intervention group). In the intervention group, swallowing function screening and rehabilitation based on each patient’s dysfunction were led by SLHT. The start of oral intake, length of oral intake rehabilitation, and length of the postoperative stay were compared in the two groups. The patient’s subgroups in the 276 patients were examined to clarify the more effectiveness of the intervention. The start of oral intake was significantly earlier in the intervention group (POD: 11 vs. 8 days; P = 0.009). In the subgroup analysis, the length of the postoperative stay was also significantly shortened by the swallowing intervention in patients without complications (POD: 18 vs. 14 days; P = 0.001) and with recurrent laryngeal nerve paralysis (RLNP) (POD: 30 vs. 21.5 days; P = 0.003). A multivariate regression analysis identified the swallowing intervention as a significant independent factor for the earlier start of oral intake and a shorter postoperative stay in patients without complications and with RLNP. Our proposed swallowing intervention is beneficial for the earlier start of oral intake and discharge after esophagectomy, particularly in patients without complications and with RLNP. This program may contribute to enhanced recovery after surgery.

scholarly journals Rehabilitation Nursing Intervention Can Improve Dysphagia and Quality of Life of Patients Undergoing Radiotherapy for Esophageal Cancer

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Xiange Zeng ◽  
Ling Li ◽  
Wenjing Wang ◽  
Lihui Zhu
Keyword(s):  
Quality Of Life ◽  
Esophageal Cancer ◽  
Intervention Group ◽  
Life Quality ◽  
Nursing Intervention ◽  
Control Group ◽  
Swallowing Function ◽  
Acute Radiation Injury ◽  
Random Number Table

Objective. To seek the improvement of rehabilitation nursing intervention on dysphagia and quality of life of patients with esophageal cancer undergoing radiotherapy. Methods. A total of 109 patients with esophageal cancer undergoing radiotherapy were selected as research objects. According to the random number table, they were separated into the control group (CG) and intervention group (IG), with 45 cases in CG and 64 cases in IG. In CG, patients were given routine nursing intervention, while those in IG were given rehabilitation nursing intervention. After intervention, the degree of acute radiation injury and the improvement of swallowing function were observed to compare the self-nursing ability, quality of life, and incidence of complications between the two groups. Results. The degree of injury in CG was heavier than that in IG. The improvement of swallowing function in IG was better than that in CG. The scores of self-nursing ability and life quality in IG were higher than those in CG, with statistically significant differences ( p < 0.05 ). The incidence of complications in IG was obviously lower than that in CG ( p < 0.05 ). Conclusion. Rehabilitation nursing intervention can ameliorate dysphagia, improve the quality of life, and reduce the incidence of complications for patients with esophageal cancer undergoing radiotherapy. It is worthy of clinical application.

scholarly journals 1511CIMmH, an mHealth Comprehensive Intervention Model for esophageal cancer patients: A Multi-center RCT Protocol

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
He Xu ◽  
Yan Guo ◽  
Yu Zeng ◽  
Yiran Li ◽  
Mengting Zhu
Keyword(s):  
Esophageal Cancer ◽  
Physical Exercise ◽  
Cancer Patients ◽  
Intervention Group ◽  
Psychological Support ◽  
Walking Distance ◽  
Control Group ◽  
Intervention Model ◽  
Potential Cost ◽  
Comprehensive Intervention

Abstract Background Post-esophagectomy patients often experience a clinically relevant deterioration of quality of life after esophagectomy due to malnutrition, impaired exercise capacity, and psychological problems. The widespread use of mobile health (mHealth) has been increasingly promising for interdisciplinary healthcare givers to deliver efficient and potential cost-effective interventions in cancer patients. However, comprehensive interventions delivered by mHealth with a rigorous design of randomized controlled trial in post-esophagectomy patients were scarce. Methods This study developed the first comprehensive intervention model by mHealth with a parallel RCT design, providing nutrition, physical exercise, and psychological support for post-esophagectomy patients. A total of 120 patients will be randomized into the intervention group or the control group receiving treatment as usual. Participants in the intervention group will receive the 3-month intervention of the CIMmH program via the enhanced WeChat platform and by specialists (offline). The online program includes nutrition guidelines, physical exercise instructions, and psychological courses. All participants will be assessed at baseline, 1, and 3 months after esophagectomy. The primary outcomes are health-related QOL, weight, and physical fitness measured by 6-minute walking distance. Secondary outcomes include nutritional biomarkers, body composition, strength, interleukin-6, depressive symptoms, anxiety, and coping. Discussion This study is among the first efforts to innovatively develop a comprehensive intervention program to prompt rehabilitation in post-esophagectomy patients. Once proven effective, CIMmH could be integrated into the management of post-esophagectomy patients. Key messages Esophageal cancer, QOL, Nutrition, Physical exercise, Psychological support, mHealth

scholarly journals Effect of Postoperative Oral Intake on Prognosis for Esophageal Cancer

Nutrients ◽  
2019 ◽  
Vol 11 (6) ◽  
pp. 1338 ◽  
Author(s):  
Genya Okada ◽  
Chika Momoki ◽  
Daiki Habu ◽  
Chisako Kambara ◽  
Tamotsu Fujii ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Nutritional Status ◽  
Enhanced Recovery ◽  
Oral Intake ◽  
Control Group ◽  
Nutritional Requirement ◽  
Lower Survival Rate ◽  
Poor Oral Intake ◽  
Prolonged Hospital ◽  
The Relationship

Background: Patients undergoing surgery for esophageal cancer are at risk of prolonged hospital stay for postoperative malnutrition. Postoperative early oral feeing is a part of the “enhanced recovery after surgery protocol” for coping with this risk. However, the usefulness of early oral intake during perioperatively is questionable. Methods: In total, 117 patients treated surgically for esophageal cancer were analyzed in the study. We assessed the oral energy sufficiency rate per nutritional requirement (oral-E/NR) at the fourth week postoperatively and classified the patients into two groups: Poor oral intake group (POI group; <25% oral-E/NR) and the control group (≥25% oral-E/NR). We analyzed the relationship among postoperative oral intake and prognoses. Results: The POI group had worse postoperative nutritional status and a lower survival rate than the control group. In a multivariate analysis, <25% oral-E/NR was one of the independent factors contributing to negative outcomes postoperatively (adjusted hazard ratio: 2.70, 95% confidence interval: 1.30–5.61). Conclusions: In patients undergoing surgery for esophageal cancer, poor postoperative oral intake negatively affected not only on their postoperative nutritional status but also their overall prognosis. It is necessary to improve the adequacy of oral intake postoperatively for patients with esophageal cancer.

scholarly journals Ultrasound-guided bilateral erector spinae plane block in laparoscopic colon cancer surgery

2021 ◽  
Author(s):  
Qijin Li ◽  
Quanchu Li ◽  
Weiping Peng ◽  
Zhenzhen Liu ◽  
Yaohai Mai ◽  
...  
Keyword(s):  
Colon Cancer ◽  
General Anesthesia ◽  
Enhanced Recovery ◽  
Intervention Group ◽  
Oral Intake ◽  
Erector Spinae ◽  
Control Group ◽  
Ultrasound Guided ◽  
Erector Spinae Plane Block ◽  
Laparoscopic Colon

Abstract Background The efficacy of erector spinae plane block (ESPB) for pain control in other surgeries remains an interesting topic of discussion. This study aimed to evaluate the safety and efficacy and quality of recovery of ultrasound-guided bilateral ESPB in laparoscopic surgery for colon cancer. Material and methods In this study 50 patients were included and randomly divided into the intervention group (E group, n = 25) and the control group (C group, n = 25). Patients in the E group received general anesthesia with preoperative bilateral ultrasound-guided ESPB, whereas patients in the C group received general anesthesia with saline injection in the erector spinae plane preoperatively. Data on intraoperative and postoperative anesthetic effects and the effect on enhanced recovery after surgery were recorded and analyzed. Results Rocuronium consumption in the intervention group was 82.80 ± 21.70 mg, which was lower than that in the control group (P < 0.05). Visual analog scale scores at 2, 6, and 24 h after surgery in the intervention group were lower than those in the control group (Fbetween = 34.034, P = 0.000). The time to ambulation, consumption of ketorolac tromethamine, time to oral intake and hospital stay after operation in the intervention group were significantly lower than those in the control group (P < 0.05). The block area at the different baselines was significant (Fbetween = 3.211, P = 0.009). The association between baseline and time was significant (Fbaseline * time = 3.268, P = 0.001). Conclusion This study confirmed that ultrasound-guided ESPB technology is safe and beneficial for patients with colon cancer undergoing laparoscopic colon surgery.

scholarly journals Effect of Respiratory Muscle Training on Dysphagia in Stroke Patients - A Retrospective Pilot Study

2020 ◽  
Author(s):  
Robert J. Arnold ◽  
Nina Bausek
Keyword(s):  
Respiratory Muscle ◽  
Intervention Group ◽  
Oral Intake ◽  
Respiratory Muscle Training ◽  
Control Group ◽  
Muscle Training ◽  
Stroke Patients ◽  
Post Intervention ◽  
Swallowing Function ◽  
Expiratory Muscle

AbstractBackgroundDysphagia is prevalent with cerebrovascular accidents and contributes to the burden of disease and mortality. Strengthening of the dysfunctional swallow muscles through respiratory muscle training (RMT) has proven effective in improving swallow effectiveness and safety. However, approaches to strengthen only the expiratory muscle groups (EMST) dominate the clinical study literature, with variable outcomes. This study investigated the effect of a simultaneous inspiratory and expiratory muscle strengthening strategy to improve swallowing function in stroke patients.MethodsTwenty post-stroke patients were randomly assigned to either intervention group (IG) or control group (CG). The intervention group was treated with three 5-minute sessions of resistive respiratory muscle training every day for 28 days, while the control group received no RMT. Respiratory and swallow outcomes were assessed pre- and post-intervention and included Mann Assessment of Swallowing Ability (MASA), Fiberoptic Endoscopic Evaluation of Swallowing (FEES) with Penetration/Aspiration Scale (PAS), Functional Oral Intake Scale (FOIS), patient visual analogue scale (VAS), and peak expiratory flow (PEF).ResultsAfter 28 days, the intervention group demonstrated greater improvements (pVal < 0.05) in PEF (IG: 168.03% vs CG: 17.47%), VAS (IG: 103.85% vs CG: 27.54%), MASA (IG: 37.28% vs CG: 6.92%), PAS (IG: 69.84% vs CG: 12.12%), and FOIS (IG: 93.75% vs CG: 21.21%).ConclusionCombined resistive inspiratory and expiratory muscle training is a feasible and effective method to improve signs and symptoms of dysphagia in stroke patients.

Auricular field nerve stimulation using the NSS-2 BRIDGE® device as an alternative to opioids following kidney donor surgery

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Jacques E. Chelly ◽  
Amy L. Monroe ◽  
Raymond M. Planinsic ◽  
Amit Tevar ◽  
Brittany E. Norton
Keyword(s):  
Enhanced Recovery ◽  
Randomized Study ◽  
Cranial Nerves ◽  
Oral Morphine ◽  
Oral Intake ◽  
Control Group ◽  
Hospital Data ◽  
Kidney Donor ◽  
Post Surgery ◽  
Post Operative Nausea

Abstract Objectives The purpose of this study was to investigate the role that the NSS-2 BRIDGE® device, an auricular field nerve stimulator, may play in reducing opioid requirement and pain in kidney donor surgery. It was not a randomized study. Electrophysiologic studies have demonstrated that the stimulation of the cranial nerves produced by the NSS-2 BRIDGE® device modulates the ascending/descending spinal pain pathways, especially at the level of the limbic system. Methods The design compared the effects of the NSS-2 BRIDGE® device (NSS 2-BRIDGE® device group; n=10) to a control group (n=10). In both groups, the surgery was performed using the same standard enhanced recovery after surgery protocol based on the use of a multimodal analgesic approach. For the active treatment group, the NSS-2 BRIDGE® device was placed in the post anesthesia care unit. The primary endpoint was opioid requirement (oral morphine equivalent, OME in mg) at 24 h post-surgery. Secondary endpoints included pain (0–10), at 24 and 48 h, time to discharge from the recovery room, incidence of post-operative nausea and vomiting at 24 h, time to oral intake, time to ambulation, and time to discharge from the hospital. Data was analyzed using unpaired t-test and presented as mean ± standard deviation. Results Compared to control, the use of the NSS-2 BRIDGE® was associated with a 75.4% reduction in OME (33.6 vs. 8.3 mg; p=0.03) and 41.5% reduction in pain (5 vs. 3.28; p=0.06) at 24 h and a 73.3% difference in pain at 48 h (1.6 ± 1.6 vs. 6.0 ± 2.8; p=0.0004). There was no difference in non-opioid analgesics administration between groups. Conclusions The tolerability of NSS-2 BRIDGE® device was reported by most to be excellent. This study suggests that the NSS-2 BRIDGE® device may represent a complementary approach for controlling postoperative opioid consumption and pain in patients undergoing kidney donation.

scholarly journals Efektivitas Slow Stroke Back Massage Dengan Minyak Aromaterapi Lavender Terhadap Penurunan Nyeri Penderita Kanker Serviks

2019 ◽  
Vol 6 (1) ◽  
pp. 35-39
Author(s):  
Sri Setyowati ◽  
Anik Rakhmawati ◽  
Sumarsih Sumarsih ◽  
Maria Indri Wigatiningsih
Keyword(s):  
Cervical Cancer ◽  
Cancer Patients ◽  
Intervention Group ◽  
Pharmacological Therapy ◽  
Wilcoxon Test ◽  
Bivariate Analysis ◽  
Control Group ◽  
Purposive Sampling ◽  
Randomized Control ◽  
Back Massage

Pain is one of the main complaints of patients with Cervical cancer patients caused due to tumor growth, infiltrats, the effects of repeated diagnostics and treatment procedures. The types of treatment which are often given to the patients are pharmacological therapies or drugs, which can provide many side effects when used in the long term. This study aimed to know the effects of slow stroke back massage technique combined with  lavender aromaterapy oil to reduce pain in patients with Cervical cancer in Dr. Kariadi Hospital. This study was a quantitative quasi experiment with randomized control group pretest-posttest design. The sampling was purposive sampling. The study involved 15 participants in the intervention group and 15 participants in the control group. The data were analyzed by univariate and bivariate analysis using wilcoxon test. The results showed that there were reduction of pain in the intervention groups with p = 0.000. This study revealed that slow stroke back massage technique combined with  lavender aromaterapy oil techniques as a non-pharmacological therapy provided an effect on the decrease of pain in cervical cancer patients. Based on the study, it is suggested that nurses apply slow stroke back massage technique combined with lavender aromaterapy oil techniques as a non-pharmacological therapy to reduce pain in cervical cancer patients. Keywords: Pain, cervical cancer, slow stroke back massage, lavender aromaterapy oil   Nyeri adalah salah satu keluhan utama pada pasien kanker serviks disebabkan karena pertumbuhan tumor, infiltrat di tempat lain, efek dari prosedur diagnostik dan perawatan yang berulang. Penanganan nyeri yang sering kali diberikan adalah pemberian terapi farmakologi atau obat-obatan yang memberikan banyak efek samping apabila digunakan dalam jangka waktu lama. Penelitian ini bertujuan untuk mengetahui pengaruh teknik slow stroke back massage dengan minyak aromaterapi lavender terhadap penurunan nyeri pada pasien kanker serviks di RSUP Dr Kariadi Semarang. Penelitian ini merupakan penelitian kuantitatif quasy eksperimental dengan metode randomized  control group pre test posttest design. Pengambilan sampel dilakukan dengan teknik purposive sampling yaitu 15 responden sebagai kelompok intervensi dan 15 responden sebagai kelompok kontrol. Analisa data dilakukan secara bivariat dan univariat dengan menggunakan uji wilcoxon. Hasil penelitian menunjukkan terdapat perbedaan penurunan nyeri pada kelompok intervensi yang diberikan terapi slow stroke back massage dengan aromaterapi lavender dengan nilai p=0.000. Kesimpulan penelitian ini membuktikan bahwa teknik slow stroke back massage dengan minyak aromaterapi lavender sebagai terapi non farmakologis berpengaruh terhadap penurunan nyeri pada pasien kanker serviks. Saran: perawat diharapkan mengaplikasikan teknik slow stroke back massage dengan minyak aromaterapi lavender sebagai terapi non farmakologis untuk menurunan nyeri pada pasien kanker serviks. Kata kunci: Nyeri, Kanker Serviks, slow stroke back massage, minyak aromaterapi lavender  

scholarly journals Manajemen Fatigue melalui Kombinasi Aerobik dengan Relaksasi Yoga pada Penderita Kanker Payudara dalam Program Kemoterapi

2017 ◽  
Vol 5 (2) ◽  
pp. 29
Author(s):  
Muhammad Taukhid
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Sampling Methods ◽  
Intervention Group ◽  
Control Group ◽  
Relaxation Techniques ◽  
Before And After ◽  
Post Test ◽  
Quasi Experimental ◽  
History Of

Background : Fatigue is feeling tired physically, psychologically, cognitively perceived cancer patients while undergoing therapies for the disease, including chemotherapy. The purpose of this study was to determine differences in the level of fatigue in cancer patients between before and after aerobic exercise combined with relaxation techniques of yoga. Methods :  This study used Quasi-experimental design with pretest-posttest control group in patients with breast cancer in the course of chemotherapy. The sampling methods used purposive sampling. The fatigue level was collected by subjective instruments Pipper Fatigue Scale (PFS), and then analyzed by the Independent and Dependent T test, and multivariate analysis used linear regression with a significance value of α 0.05. Results :  There were differences in the level of fatigue post-test between the intervention group and the control group with a difference of 1.25 (p = 0.013). History of previous exercise may explain the 17.8% level of fatigue that occurs in patients with breast cancer in the course of chemotherapy, the rest was explained by other variables. Conclusion : There were a decrease in the level fatigue statistically, however clinically the level of fatigue remain the same catagories.

scholarly journals Enhanced recovery after surgery protocol for prostate cancer patients undergoing laparoscopic radical prostatectomy

2018 ◽  
Vol 47 (1) ◽  
pp. 114-121 ◽  
Author(s):  
Chunhua Lin ◽  
Fengchun Wan ◽  
Youyi Lu ◽  
Guojun Li ◽  
Luxin Yu ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Cancer Patients ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
The Body ◽  
Laparoscopic Radical Prostatectomy ◽  
Control Group ◽  
Tube Removal ◽  
Hospitalization Costs

Objective To determine the value of an enhanced recovery after surgery (ERAS) protocol for prostate cancer patients undergoing laparoscopic radical prostatectomy (LRP). Methods We conducted a retrospective cohort study using clinical data for 288 patients who underwent LRP in our hospital from June 2010 to December 2016. A total of 124 patients underwent ERAS (ERAS group) and the remaining 164 patients were allocated to the control group. ERAS comprised prehabilitation exercise, carbohydrate fluid loading, targeted intraoperative fluid resuscitation and keeping the body warm, avoiding drain use, early mobilization, and early postoperative drinking and eating. Results The times from LRP to first water intake, first ambulation, first anal exhaust, first defecation, pelvic drainage-tube removal, and length of hospital stay (LOS) were all significantly shorter, and hospitalization costs and the incidence of postoperative complications were significantly lower in the ERAS group compared with the control group. No deaths or reoperations occurred in either group, and there were no readmissions in the ERAS group, within 90 days after surgery. Conclusion ERAS protocols may effectively accelerate patient rehabilitation and reduce LOS and hospitalization costs in patients undergoing LRP.

scholarly journals Impact of Enhanced Recovery after Surgery with Preoperative Whey Protein-Infused Carbohydrate Loading and Postoperative Early Oral Feeding among Surgical Gynecologic Cancer Patients: An Open-Labelled Randomized Controlled Trial

Nutrients ◽  
2020 ◽  
Vol 12 (1) ◽  
pp. 264 ◽  
Author(s):  
Ho Chiou Yi ◽  
Zuriati Ibrahim ◽  
Zalina Abu Zaid ◽  
Zulfitri ‘Azuan Mat Daud ◽  
Nor Baizura Md. Yusop ◽  
...  
Keyword(s):  
Whey Protein ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Gynecologic Cancer ◽  
Intervention Group ◽  
Oral Feeding ◽  
Control Group ◽  
Early Oral Feeding ◽  
Significant Difference ◽  
The Impact

Enhanced Recovery after Surgery (ERAS) with sole carbohydrate (CHO) loading and postoperative early oral feeding (POEOF) shortened the length of postoperative (PO) hospital stays (LPOHS) without increasing complications. This study aimed to examine the impact of ERAS with preoperative whey protein-infused CHO loading and POEOF among surgical gynecologic cancer (GC) patients. There were 62 subjects in the intervention group (CHO-P), which received preoperative whey protein-infused CHO loading and POEOF; and 56 subjects formed the control group (CO), which was given usual care. The mean age was 49.5 ± 12.2 years (CHO-P) and 51.2 ± 11.9 years (CO). The trial found significant positive results which included shorter LPOHS (78.13 ± 33.05 vs. 99.49 ± 22.54 h); a lower readmission rate within one month PO (6% vs. 16%); lower weight loss (−0.3 ± 2.3 kg vs. −2.1 ± 2.3 kg); a lower C-reactive protein–albumin ratio (0.3 ± 1.2 vs. 1.1 ± 2.6); preserved muscle mass (0.4 ± 1.7 kg vs. −0.7 ± 2.6 kg); and better handgrip strength (0.6 ± 4.3 kg vs. −1.9 ± 4.7 kg) among CHO-P as compared with CO. However, there was no significant difference in mid-upper arm circumference and serum albumin level upon discharge. ERAS with preoperative whey protein-infused CHO loading and POEOF assured better PO outcomes.

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