Preoperative inspiratory muscle training preserved diaphragmatic excursion after esophagectomy: a randomized-controlled trial.

IF 2.2 4区 医学 Q3 GASTROENTEROLOGY & HEPATOLOGY
Hiroki Mizusawa, Yuji Higashimoto, Osamu Shiraishi, Masashi Shiraishi, Ryuji Sugiya, Masaya Noguchi, Kengo Kanki, Tamotsu Kimura, Akira Ishikawa, Takushi Yasuda
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引用次数: 0

Abstract

Background: Preoperative inspiratory muscle training (IMT) enhances diaphragmatic excursion (DE) in patients with esophageal cancer; however, the postoperative effects of IMT on DE have not yet been evaluated. This study aimed to investigate the effect of preoperative IMT on perioperative diaphragmatic function as measured by DE, inspiratory muscle strength, lung function, and exercise tolerance.

Methods: This was a parallel, randomized-controlled trial. Patients with thoracic or abdominal esophageal cancer scheduled for esophagectomy were randomized into either the incentive spirometry (IS) or IMT group. Each intervention was performed during preoperative neoadjuvant chemotherapy (NAC). The primary outcome was the DE, and the secondary outcomes were maximal inspiratory pressure (MIP), lung function, and exercise tolerance, which were measured before and 1-3 months after esophagectomy.

Results: Thirty-two patients were included in the analysis. The DE in the IMT group (n = 15) increased from baseline to pre-operation, and the rate of change was significantly greater than that in the IS group (n = 17). Although the DE and MIP decreased in both groups after esophagectomy, the decline in the DE after esophagectomy was significantly lower in the IMT group than that in the IS group (p < 0.05). Furthermore, significant differences in DE persisted at least until 3 months post-esophagectomy, whereas MIP did not differ significantly at any time point. Pulmonary function and exercise tolerance were not significantly different between the two groups.

Conclusions: The IMT before esophagectomy enhanced diaphragmatic function, which was preserved for more than 3 months after esophagectomy.

术前吸气肌训练可保护食管切除术后膈肌移位:一项随机对照试验。
背景:术前吸气肌训练(IMT)可增强食管癌患者的膈肌偏移(DE);然而,术后IMT对DE的影响尚未得到评估。本研究旨在探讨术前IMT对围手术期膈肌功能的影响,包括DE、吸气肌力量、肺功能和运动耐量。方法:这是一项平行、随机对照试验。计划行食管切除术的胸腹食管癌患者被随机分为激励肺活量测定(IS)组或IMT组。每次干预均在术前新辅助化疗(NAC)期间进行。主要终点是DE,次要终点是最大吸气压(MIP)、肺功能和运动耐量,分别在食管切除术前和术后1-3个月测量。结果:32例患者纳入分析。IMT组(n = 15) DE从基线到术前升高,变化率明显大于IS组(n = 17)。虽然两组食管切除术后DE和MIP均有所下降,但IMT组食管切除术后DE的下降幅度明显低于IS组(p结论:食管切除术前IMT可增强食管切除术后膈功能,并可在食管切除术后保存3个月以上。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Esophagus
Esophagus GASTROENTEROLOGY & HEPATOLOGY-
CiteScore
4.90
自引率
8.30%
发文量
78
审稿时长
>12 weeks
期刊介绍: Esophagus, the official journal of the Japan Esophageal Society, introduces practitioners and researchers to significant studies in the fields of benign and malignant diseases of the esophagus. The journal welcomes original articles, review articles, and short articles including technical notes ( How I do it ), which will be peer-reviewed by the editorial board. Letters to the editor are also welcome. Special articles on esophageal diseases will be provided by the editorial board, and proceedings of symposia and workshops will be included in special issues for the Annual Congress of the Society.
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