{"title":"Achievements of perioperative assist team medical care in esophageal cancer surgery, Tokushima University Hospital.","authors":"Seiya Inoue, Masakazu Goto, Satoshi Fujiwara, Takahiro Yoshida, Fuyumi Izaki, Taihei Takeuchi, Hiroyuki Sumitomo, Mariko Misaki, Hiroaki Toba, Hiromitsu Takizawa, Yasuhiro Hamada, Tetsuya Matsuura, Keiko Aota, Hidenori Takano","doi":"10.2152/jmi.71.279","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Radical esophagectomy is highly invasive and associated with many postoperative complications. A decline in postoperative QOL is a serious issue for patients, and comprehensive perioperative management through multidisciplinary cooperation is necessary. Our institution has established a perioperative assist team (OPERA) to address this need since 2017.</p><p><strong>Methods: </strong>This study included 109 patients with esophageal cancer who underwent neoadjuvant chemotherapy and esophagectomy from 2009 to 2018. O group, means OPERA intervention group, included 57 patients, and N group, means Non-OPERA intervention group, included 52 patients. The effects of the OPERA intervention on reducing chemotherapy-related adverse events and improving postoperative outcomes were retrospectively investigated.</p><p><strong>Results: </strong>The OPERA intervention significantly reduced the incidence of chemotherapy-related adverse events (P=0.002). In particular, anorexia and diarrhea, febrile neutropenia were significantly reduced (P<0.001, P=0.002, P=0.025, respectively). Postoperatively, the start date of walking was significantly earlier (P<0.001), the incidence of pneumonia was lower (P=0.022). At the time of postoperative discharge, N group was significantly greater weight loss compared to O group (P=0.002). The 5-year survival rate was longer in O group (P=0.003).</p><p><strong>Conclusion: </strong>The OPERA intervention reduced the incidence of chemotherapy-related adverse events and postoperative complications and helped improved prognosis. J. Med. Invest. 71 : 279-285, August, 2024.</p>","PeriodicalId":46910,"journal":{"name":"JOURNAL OF MEDICAL INVESTIGATION","volume":"71 3.4","pages":"279-285"},"PeriodicalIF":0.7000,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"JOURNAL OF MEDICAL INVESTIGATION","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.2152/jmi.71.279","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"MEDICINE, RESEARCH & EXPERIMENTAL","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Radical esophagectomy is highly invasive and associated with many postoperative complications. A decline in postoperative QOL is a serious issue for patients, and comprehensive perioperative management through multidisciplinary cooperation is necessary. Our institution has established a perioperative assist team (OPERA) to address this need since 2017.
Methods: This study included 109 patients with esophageal cancer who underwent neoadjuvant chemotherapy and esophagectomy from 2009 to 2018. O group, means OPERA intervention group, included 57 patients, and N group, means Non-OPERA intervention group, included 52 patients. The effects of the OPERA intervention on reducing chemotherapy-related adverse events and improving postoperative outcomes were retrospectively investigated.
Results: The OPERA intervention significantly reduced the incidence of chemotherapy-related adverse events (P=0.002). In particular, anorexia and diarrhea, febrile neutropenia were significantly reduced (P<0.001, P=0.002, P=0.025, respectively). Postoperatively, the start date of walking was significantly earlier (P<0.001), the incidence of pneumonia was lower (P=0.022). At the time of postoperative discharge, N group was significantly greater weight loss compared to O group (P=0.002). The 5-year survival rate was longer in O group (P=0.003).
Conclusion: The OPERA intervention reduced the incidence of chemotherapy-related adverse events and postoperative complications and helped improved prognosis. J. Med. Invest. 71 : 279-285, August, 2024.