{"title":"食管癌切除术患者术前和术后运动和营养治疗:一项前瞻性介入研究。","authors":"Kohei Ueno, Tatsuto Nishigori, Shinya Yoshida, Koya Hida, Shigeru Tsunoda, Hisahiro Hosogi, Shigeo Hisamori, Ryosuke Okamura, Shintaro Okumura, Seiichiro Kanaya, Ami Kobayashi, Yukiko Nobori, Kenichiro Shide, Yuji Yoshioka, Yohei Oshima, Yoshihito Goto, Kentaro Goto, Nobuya Inagaki, Shuichi Matsuda, Kazutaka Obama","doi":"10.1159/000547965","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to evaluate safety and feasibility of perioperative exercise and nutrition therapy and to explore perioperative changes in skeletal muscle mass (SMM) in patients with esophageal cancer.</p><p><strong>Methods: </strong>Patients scheduled for curative esophagectomy at two hospitals were enrolled. Exercise and nutrition therapy were performed for 3 weeks preoperatively and 4 weeks postoperatively. Outcomes included SMM, which was the sum of both mid-thigh cross-sectional area on computed tomography and physical function, assessed at T1 (intervention start), T2 (just before surgery), and T3 (1-month postoperatively). The SMM change rate between T1 and T3 was compared with the hypothesized value (-7.5%) from our previous study.</p><p><strong>Results: </strong>Thirty-six patients underwent intervention and esophagectomy (intervention completion rate: 94.4%, no serious adverse events). The SMM increased by 4.9% for T1-T2 (p < 0.001) but decreased by 10.1% for T1-T3 (p < 0.001), suggesting that the primary outcome was not achieved. Physical function results were significantly better at T3 than at T1. Postoperative SMM loss was lower in patients who maintained postoperative caloric intake and physical activity than in those who could not (-8.3% vs. -15.4%, p = 0.011).</p><p><strong>Conclusions: </strong>Perioperative exercise and nutrition therapy were safe and feasible. An increase in preoperative SMM and postoperative physical function were observed, although SMM decreased after surgery. Further investigation is warranted to evaluate the efficacy of this intervention.</p>","PeriodicalId":8269,"journal":{"name":"Annals of Nutrition and Metabolism","volume":" ","pages":"1-10"},"PeriodicalIF":2.9000,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Pre- and Post-Operative Exercise and Nutrition Therapy in Patients with Esophageal Cancer Undergoing Esophagectomy: A Prospective Interventional Study.\",\"authors\":\"Kohei Ueno, Tatsuto Nishigori, Shinya Yoshida, Koya Hida, Shigeru Tsunoda, Hisahiro Hosogi, Shigeo Hisamori, Ryosuke Okamura, Shintaro Okumura, Seiichiro Kanaya, Ami Kobayashi, Yukiko Nobori, Kenichiro Shide, Yuji Yoshioka, Yohei Oshima, Yoshihito Goto, Kentaro Goto, Nobuya Inagaki, Shuichi Matsuda, Kazutaka Obama\",\"doi\":\"10.1159/000547965\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>This study aimed to evaluate safety and feasibility of perioperative exercise and nutrition therapy and to explore perioperative changes in skeletal muscle mass (SMM) in patients with esophageal cancer.</p><p><strong>Methods: </strong>Patients scheduled for curative esophagectomy at two hospitals were enrolled. Exercise and nutrition therapy were performed for 3 weeks preoperatively and 4 weeks postoperatively. Outcomes included SMM, which was the sum of both mid-thigh cross-sectional area on computed tomography and physical function, assessed at T1 (intervention start), T2 (just before surgery), and T3 (1-month postoperatively). The SMM change rate between T1 and T3 was compared with the hypothesized value (-7.5%) from our previous study.</p><p><strong>Results: </strong>Thirty-six patients underwent intervention and esophagectomy (intervention completion rate: 94.4%, no serious adverse events). The SMM increased by 4.9% for T1-T2 (p < 0.001) but decreased by 10.1% for T1-T3 (p < 0.001), suggesting that the primary outcome was not achieved. Physical function results were significantly better at T3 than at T1. Postoperative SMM loss was lower in patients who maintained postoperative caloric intake and physical activity than in those who could not (-8.3% vs. -15.4%, p = 0.011).</p><p><strong>Conclusions: </strong>Perioperative exercise and nutrition therapy were safe and feasible. An increase in preoperative SMM and postoperative physical function were observed, although SMM decreased after surgery. Further investigation is warranted to evaluate the efficacy of this intervention.</p>\",\"PeriodicalId\":8269,\"journal\":{\"name\":\"Annals of Nutrition and Metabolism\",\"volume\":\" \",\"pages\":\"1-10\"},\"PeriodicalIF\":2.9000,\"publicationDate\":\"2025-08-18\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Annals of Nutrition and Metabolism\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1159/000547965\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"ENDOCRINOLOGY & METABOLISM\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annals of Nutrition and Metabolism","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1159/000547965","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}
引用次数: 0
摘要
前言:本研究旨在评价围手术期运动和营养治疗的安全性和可行性,探讨食管癌患者骨骼肌质量(SMM)的变化。方法:选取两家医院计划施行根治性食管切除术的患者。术前3周,术后4周进行运动和营养治疗。结果包括SMM,即在T1(干预开始)、T2(手术前)和T3(术后1个月)评估的计算机断层扫描大腿中部截面积和身体功能的总和。T1和T3之间的SMM变化率与我们先前研究的假设值(-7.5%)进行比较。结果:36例患者行干预及食管切除术,干预完成率94.4%,无严重不良事件发生。T1-T2期SMM升高4.9% (p < 0.001),而T1-T3期SMM下降10.1% (p < 0.001),提示未达到主要结局。生理功能结果在T3明显优于T1。术后维持热量摄入和体力活动的患者SMM损失低于不能维持热量摄入和体力活动的患者(-8.3% vs -15.4%, p = 0.011)。结论:围手术期运动和营养治疗安全可行。观察到术前SMM和术后身体功能的增加,尽管手术后SMM下降。需要进一步的研究来评估这种干预措施的有效性。
Pre- and Post-Operative Exercise and Nutrition Therapy in Patients with Esophageal Cancer Undergoing Esophagectomy: A Prospective Interventional Study.
Introduction: This study aimed to evaluate safety and feasibility of perioperative exercise and nutrition therapy and to explore perioperative changes in skeletal muscle mass (SMM) in patients with esophageal cancer.
Methods: Patients scheduled for curative esophagectomy at two hospitals were enrolled. Exercise and nutrition therapy were performed for 3 weeks preoperatively and 4 weeks postoperatively. Outcomes included SMM, which was the sum of both mid-thigh cross-sectional area on computed tomography and physical function, assessed at T1 (intervention start), T2 (just before surgery), and T3 (1-month postoperatively). The SMM change rate between T1 and T3 was compared with the hypothesized value (-7.5%) from our previous study.
Results: Thirty-six patients underwent intervention and esophagectomy (intervention completion rate: 94.4%, no serious adverse events). The SMM increased by 4.9% for T1-T2 (p < 0.001) but decreased by 10.1% for T1-T3 (p < 0.001), suggesting that the primary outcome was not achieved. Physical function results were significantly better at T3 than at T1. Postoperative SMM loss was lower in patients who maintained postoperative caloric intake and physical activity than in those who could not (-8.3% vs. -15.4%, p = 0.011).
Conclusions: Perioperative exercise and nutrition therapy were safe and feasible. An increase in preoperative SMM and postoperative physical function were observed, although SMM decreased after surgery. Further investigation is warranted to evaluate the efficacy of this intervention.
期刊介绍:
''Annals of Nutrition and Metabolism'' is a leading international peer-reviewed journal for sharing information on human nutrition, metabolism and related fields, covering the broad and multidisciplinary nature of science in nutrition and metabolism. As the official journal of both the International Union of Nutritional Sciences (IUNS) and the Federation of European Nutrition Societies (FENS), the journal has a high visibility among both researchers and users of research outputs, including policy makers, across Europe and around the world.