دورية أكاديمية
Does prehabilitation before esophagectomy improve postoperative outcomes? A systematic review and meta-analysis.
| العنوان: | Does prehabilitation before esophagectomy improve postoperative outcomes? A systematic review and meta-analysis. |
|---|---|
| المؤلفون: | An KR; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA.; Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York, NY, USA.; Division of Cardiac Surgery, Department of Surgery, University of Toronto, Toronto, ON, Canada., Seijas V; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA.; Division of Rehabilitation, Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland.; Ageing, Functioning Epidemiology, and Implementation, Swiss Paraplegic Research, Nottwil, Switzerland.; Department of Physical and Rehabilitation Medicine, Rehabilitation in Health Research Group, University of Antioquia, Medellin, Colombia., Xu MS; Division of General Surgery, Department of Surgery, University of Toronto, Toronto, ON, Canada., Grüßer L; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA.; Department of Anesthesiology, University Hospital RWTH Aachen, Aachen, Germany., Humar S; Michael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada., Moreno AA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA.; Division of Pediatric Surgery, Department of Surgery, University of the Philippines-Philippine General Hospital, Manila, The Philippines., Turk M; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA.; Division of Plastic & Reconstructive Surgery, Department of Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA., Kasanagottu K; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA.; Division of General Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Harvard University, Boston, MA, USA., Alzghari T; Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York, NY, USA., Dimagli A; Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York, NY, USA., Ko MA; Division of Thoracic Surgery, Department of Surgery, St. Joseph's Health Centre, University of Toronto, Toronto, ON, Canada., Villena-Vargas J; Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York, NY, USA., Papatheodorou S; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA., Gaudino MFL; Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York, NY, USA. |
| المصدر: | Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus [Dis Esophagus] 2024 Feb 29; Vol. 37 (3). |
| نوع المنشور: | Meta-Analysis; Systematic Review; Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Oxford University Press Country of Publication: United States NLM ID: 8809160 Publication Model: Print Cited Medium: Internet ISSN: 1442-2050 (Electronic) Linking ISSN: 11208694 NLM ISO Abbreviation: Dis Esophagus Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2017- : New York : Oxford University Press Original Publication: Milano : Masson, 1988- |
| مواضيع طبية MeSH: | Esophageal Neoplasms*/surgery , Pneumonia*/epidemiology , Pneumonia*/etiology , Pneumonia*/prevention & control, Humans ; Esophagectomy/adverse effects ; Intensive Care Units ; Preoperative Exercise ; Randomized Controlled Trials as Topic ; Observational Studies as Topic |
| مستخلص: | Esophagectomy for esophageal cancer is associated with high morbidity. It remains unclear whether prehabilitation, a strategy aimed at optimizing patients' physical and mental functioning prior to surgery, improves postoperative outcomes. A systematic review and meta-analysis was conducted to evaluate the effect of prehabilitation on post-operative outcomes after esophagectomy. Data sources included Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, CINAHL, and PEDro, with information from 1 January 2000 to 5 August 2023. The analysis included randomized controlled trials and observational studies that compared prehabilitation interventions to standard care prior to esophagectomy. A random effects model was used to generate a pooled estimate for pairwise meta-analysis, meta-analysis of proportions, and meta-analysis of means. A total of 1803 patients were included with 584 in randomized controlled trials (RCTs) and 1219 in observational studies. In the randomized evidence, there were no significant differences between prehabilitation and control in the odds of postoperative pneumonia (15.0 vs. 18.9%, odds ratio (OR) 1.06 [95% confidence interval (CI): 0.66;1.72]) or pulmonary complications (14 vs. 25.6%, OR 0.68 [95% CI: 0.32;1.45]). In the observational data, there was a reduction in both postoperative pneumonia (22.5 vs. 32.9%, OR 0.48 [95% CI: 0.28;0.83]) and pulmonary complications (26.1 vs. 52.3%, OR 0.35 [95% CI: 0.17;0.75]) with prehabilitation. Hospital and intensive care unit length of stay (days), operative mortality, and severe complications (Clavien-Dindo ≥ 3) did not differ between groups in both the randomized data and observational data. Prehabilitation demonstrated reductions in postoperative pneumonia and pulmonary complications in observational studies, but not RCTs. The overall certainty of these findings is limited by the low quality of the available evidence. (© The Author(s) 2023. Published by Oxford University Press on behalf of International Society for Diseases of the Esophagus. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.) |
| فهرسة مساهمة: | Keywords: complications; esophageal cancer; esophageal cancer surgery; esophageal surgery; esophageal tumor; esophagectomy; esophagogastrectomy; esophagus carcinoma; oesophageal cancer; oesophageal cancer surgery; oesophageal surgery; oesophageal tumor; oesophagectomy; oesophagogastrectomy; oesophagus carcinoma; perioperative care; preoperative exercise; rehabilitation; rehabilitation medicine |
| تواريخ الأحداث: | Date Created: 20231129 Date Completed: 20240304 Latest Revision: 20240308 |
| رمز التحديث: | 20240309 |
| DOI: | 10.1093/dote/doad066 |
| PMID: | 38018252 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 1442-2050 |
|---|---|
| DOI: | 10.1093/dote/doad066 |