RA02.09: THE EFFECT OF PREOPERATIVE BREATHING EXERCISE IN PATIENTS UNDERGOING ESOPHAGECTOMY FOR ESOPHAGEAL CANCER

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 22-22
Author(s):  
Hamakawa Takuya ◽  
Motohiro Hirao ◽  
Kazuhiro Nishikawa ◽  
Ayako Fujiwara ◽  
Sakae Maeda ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Respiratory Function ◽  
Vital Capacity ◽  
Conflicts Of Interest ◽  
Forced Expiratory Volume ◽  
Pulmonary Complications ◽  
Transhiatal Esophagectomy ◽  
Postoperative Pulmonary Complications ◽  
Breathing Exercise ◽  
Subtotal Esophagectomy

Abstract Background Patients with esophageal cancer often have impaired respiratory function. Postoperative pulmonary complications frequently occur in patients undergoing esophagectomy. We instructed patients undergoing esophagectomy to do breathing exercise with Incentive Spirometer Coach 2 (Smiths medical) for at least two weeks before surgery, as well as smoking cessation. Methods We retrospectively reviewed medical records of 52 esophageal cancer patients who underwent spirometry both pre- and post- Coach 2 exercise between 2009 and 2017. We evaluated the change of respiratory function and postoperative complications. The influence of exercise was analyzed between patients who underwent neoadjuvant chemotherapy (NAC group, n = 36) and those treated without NAC (non-NAC group, n = 16). Results 39 males and 13 females were included. Median age was 65 (45–82). Surgical procedures were 48 subtotal esophagectomy, 3 transhiatal esophagectomy, and 1 pharyngo-laryngo-esophagectomy. Vital capacity (VC) and forced expiratory volume in one second (FEV1.0) were significantly improved through exercise; 3405 to 3600ml (P = 0.021) and 2485 to 2555 ml (P = 0.008), respectively. NAC group included more advanced-staged cases but age and baseline respiratory function were not significantly different from non-NAC group. Interval between first and second spirometry was 31 days for non-NAC group, 69 days for NAC group. After exercise, non-NAC group showed significant improvement in VC (3135 to 3600ml, P = 0.006), FEV1.0 (2255 to 2565ml, P = 0.004), whereas NAC group showed little change in VC (3560 to 3630ml, P = 0.514), FEV1.0 (2585 to 2555ml, P = 0.514). Postoperative complication occurred in 27 of 52 cases. Postoperative pneumonia occurred in 7 (13.5%) in the present cohort, which was less frequent than 42% in the historical control cohort without breathing exercise. Conclusion Preoperative breathing exercise with Coach 2 improved respiratory function in patients without NAC. In patients with NAC, the effect of exercise was smaller than non-NAC group, still exercise might suppress the decrease of respiratory function during NAC. Breathing exercise may reduce postoperative pulmonary complications. Disclosure All authors have declared no conflicts of interest.

scholarly journals An Evaluation of Preoperative Methods of Preventing Postoperative Pulmonary Complications

1977 ◽  
Vol 5 (1) ◽  
pp. 56-59 ◽  
Author(s):  
I. C. Wheatley ◽  
K. J. Hardy ◽  
C. E. Barter
Keyword(s):  
Vital Capacity ◽  
Forced Expiratory Volume ◽  
Pulmonary Complications ◽  
Respiratory Care ◽  
Postoperative Pulmonary Complications ◽  
X Ray ◽  
Function Test ◽  
Postoperative Respiratory Complications ◽  
Chest X Ray ◽  
Intensive Physiotherapy

The effectiveness of three current regimes of preoperative respiratory care in reducing postoperative respiratory complications following herniorrhaphy was studied prospectively. No smoking for five days plus intensive physiotherapy, five days no smoking, and routine hospital admission two days preoperatively were the regimes. Clinical, bacteriological, chest X-ray, blood gas and respiratory function test data were the criteria for assessment. The same surgical and anaesthetic team performed each operation. No statistical difference between the groups for pulmonary complications was noted. A significant correlation was found between the preoperative vital capacity and arterial pO2; also between the preoperative forced expiratory volume in one second-vital capacity ratio with the postoperative arterial pO2.

Assessment of factors affecting short-term pulmonary functions following cardiac surgery: A prospective observational study

2021 ◽  
pp. 021849232110100
Author(s):  
Neetika Katiyar ◽  
Sandeep Negi ◽  
Sunder Lal Negi ◽  
Goverdhan Dutt Puri ◽  
Shyam Kumar Singh Thingnam
Keyword(s):  
Cardiac Surgery ◽  
Pulmonary Function ◽  
Forced Vital Capacity ◽  
Vital Capacity ◽  
Forced Expiratory Volume ◽  
Pulmonary Complications ◽  
Operative Morbidity ◽  
Factors Affecting ◽  
Factors Influencing ◽  
Significant Impairment

Background Pulmonary complications after cardiac surgery are very common and lead to an increased incidence of post-operative morbidity and mortality. Several factors, either modifiable or non-modifiable, may contribute to the associated unfavorable consequences related to pulmonary function. This study was aimed to investigate the degree of alteration and factors influencing pulmonary function (forced expiratory volume in one second (FEV1) and forced vital capacity), on third, fifth, and seventh post-operative days following cardiac surgery. Methods This study was executed in 71 patients who underwent on-pump cardiac surgery. Pulmonary function was assessed before surgery and on the third, fifth, and seventh post-operative days. Data including surgical details, information about risk factors, and assessment of pulmonary function were obtained. Results The FEV1 and forced vital capacity were significantly impaired on post-operative days 3, 5, and 7 compared to pre-operative values. The reduction in FEV1 was 41%, 29%, and 16% and in forced vital capacity was 42%, 29%, and 19% consecutively on post-operative days 3, 5, and 7. Multivariate analysis was done to detect the factors influencing post-operative FEV1 and forced vital capacity. Discussion This study observed a significant impairment in FEV1 and forced vital capacity, which did not completely recover by the seventh post-operative day. Different factors affecting post-operative FEV1 and forced vital capacity were pre-operative FEV1, age ≥60, less body surface area, lower pre-operative chest expansion at the axillary level, and having more duration of cardiopulmonary bypass during surgery. Presence of these factors enhances the chance of developing post-operative pulmonary complications.

scholarly journals PV-0622 NCTP model for postoperative pulmonary complications after trimodality therapy in esophageal cancer

2019 ◽  
Vol 133 ◽  
pp. S330-S331
Author(s):  
M. Thomas ◽  
G. Defraene ◽  
M. Lambrecht ◽  
W. Deng ◽  
J. Moons ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Pulmonary Complications ◽  
Postoperative Pulmonary Complications ◽  
Trimodality Therapy

scholarly journals Impact of pulmonary function on pulmonary complications after robotic-assisted thoracoscopic lobectomy

2019 ◽  
Vol 57 (2) ◽  
pp. 338-342
Author(s):  
Christopher Cao ◽  
Brian E Louie ◽  
Franca Melfi ◽  
Giulia Veronesi ◽  
Rene Razzak ◽  
...  
Keyword(s):  
Pulmonary Function ◽  
Eastern Cooperative Oncology Group ◽  
Multivariable Analysis ◽  
Primary Lung Cancer ◽  
Forced Expiratory Volume ◽  
Pulmonary Complications ◽  
Postoperative Pulmonary Complications ◽  
Univariable Analysis ◽  
Predictive Values ◽  
Group Grade

Abstract OBJECTIVES Percentage-predicted forced expiratory volume in 1 s (FEV1) and diffusing capacity for carbon monoxide (DLCO), and their predicted postoperative (ppo) values are established prognostic factors for postoperative pulmonary complications after thoracotomy. However, their predictive value for minimally invasive pulmonary resections remains controversial. This study assessed the incidence of pulmonary complications after robotic lobectomy for primary lung cancer and analysed the predictive significance of FEV1 and DLCO. METHODS This was a retrospective analysis of patients who underwent robotic lobectomy from 4 institutions. Descriptive and comparative analyses were performed for patients who experienced pulmonary complications versus patients who did not, in relation to FEV1 and DLCO values. To identify thresholds for increased complications, patients were categorized into groups of 10% incremental increases in FEV1 and DLCO, and their ppo values. RESULTS From November 2002 to April 2018, 1088 patients underwent robotic lobectomy. Overall, 169 postoperative pulmonary complications occurred in 141 patients. Male gender and Eastern Cooperative Oncology Group grade ≥1 were associated with increased pulmonary complications on univariable analysis. Patients who experienced pulmonary complications had increased mortality (2.1% vs 0.2%, P = 0.017) and longer hospitalizations (9 vs 4 days, P < 0.001). Pulmonary complications were associated when FEV1 ≤60% and DLCO ≤50%, and when ppo FEV1 or DLCO was ≤50%; ppo FEV1 ≤50% (P < 0.001) and ppo DLCO ≤50% (P = 0.031) remained statistically significant on multivariable analysis. CONCLUSIONS Both FEV1 and DLCO were shown to be significant predictors of pulmonary complications. Furthermore, thresholds of percentage-predicted and ppo FEV1 and DLCO values were identified, below which pulmonary complications occurred significantly more frequently, suggesting their predictive values are particularly useful in patients with poorer pulmonary function.

Congenital Ankyloglossia with Deviation of the Epiglottis and Larynx: Symptoms and Respiratory Function in Adults

1993 ◽  
Vol 102 (8) ◽  
pp. 620-624 ◽  
Author(s):  
Susumu Mukai ◽  
Chikako Mukai ◽  
Kazuyuki Asaoka
Keyword(s):  
Respiratory Function ◽  
Hard Palate ◽  
Vital Capacity ◽  
Forced Expiratory Volume ◽  
Wind Instruments ◽  
Class Iii ◽  
Class Iii Malocclusion ◽  
Dry Skin ◽  
Muscle Cramps ◽  
Study Population

We operated on 38 adult patients with congenital ankyloglossia with deviation of the epiglottis and larynx. The results were as follows. 1) Most patients had Angle's class III malocclusion, irregular alignment of the upper teeth, and high hard palate. 2) Fifty percent of the patients in our study population had obstructive respiratory failure. Their vital capacity increased significantly after the operation, but changes of forced expiratory volume in 1 second were not prominent. 3) Subjective symptoms of this disease were stiffness of the shoulders, a cold feeling in the extremities, an obstructed feeling in the throat, insomnia, fatigue, dry skin, irritability and/or anxiety, and nervousness. These improved postoperatively. 4) Objective symptoms included snoring, muscle cramps, difficulty in playing wind instruments, hoarseness, and incorrect articulation. The objective symptoms, except for incorrect articulation, improved postoperatively.

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