Tatematsu Noriatsu, Park Moonhwa, Tanaka Eiji, Sakai Yoshiharu, Tsuboyama Tadao
Department of Human Health Sciences, Graduate School of Medicine, Kyoto University, Japan.
Asian Pac J Cancer Prev. 2013;14(1):47-51. doi: 10.7314/apjcp.2013.14.1.47.
Postoperative complications after esophagectomy can lead to considerable patient discomfort and prolonged length of hospital stay. Lack of physical activity can be one of the independent risk factors for postoperative complications because physical activity is closely related to physical function. The objective of this study was to determine whether physical activity among esophageal cancer patients decreases their risk of postoperative complications after esophagectomy.
We investigated 51 consecutive patients with newly diagnosed resectable esophageal cancer who were scheduled to receive esophagectomy between January 2009 and November 2011. Demographic, clinicopathologic, and treatment information were recorded and physical function was measured. The last 7-days short version of the International Physical Activity Questionnaire was used to assess physical activity before the operation. Stepwise multiple logistic regression analysis was used to determine whether preoperative physical activity is related to the risk of postoperative complications.
Male gender [OR 18.6, (95%CIs: 1.2-284.4); P=0.035], 3-field lymph node dissection (OR 9.6, [95%CIs: 1.4-66.6]; P=0.022), low-level physical activity (OR 28.3, [95%CIs: 3.5-227.7]; P=0.002), and preoperative comorbidities [OR 5.9, (95%CIs: 1.1-31.5); P=0.037] were found to be independently associated with postoperative complications.
The present study shows that low-level physical activity, preoperative comorbidities, and 3-field lymph node dissection are independent and significant risk factors for postoperative complications after esophagectomy. Although further study is required, maintaining high-level physical activity preoperatively may decrease the risk of postoperative complications.
食管癌切除术后的并发症可导致患者极大的不适并延长住院时间。缺乏身体活动可能是术后并发症的独立危险因素之一，因为身体活动与身体功能密切相关。本研究的目的是确定食管癌患者的身体活动是否能降低食管癌切除术后的并发症风险。
我们调查了2009年1月至2011年11月期间计划接受食管癌切除术的51例新诊断的可切除食管癌患者。记录人口统计学、临床病理和治疗信息，并测量身体功能。使用国际身体活动问卷的最后7天简版评估术前的身体活动。采用逐步多元逻辑回归分析确定术前身体活动是否与术后并发症风险相关。
男性[比值比18.6，（95%可信区间：1.2 - 284.4）；P = 0.035]、三野淋巴结清扫（比值比9.6，[95%可信区间：1.4 - 66.6]；P = 0.022）、低水平身体活动（比值比28.3，[95%可信区间：3.5 - 227.7]；P = 0.002）和术前合并症[比值比5.9，（95%可信区间：1.1 - 31.5）；P = 0.037]被发现与术后并发症独立相关。
本研究表明，低水平身体活动、术前合并症和三野淋巴结清扫是食管癌切除术后并发症的独立且显著的危险因素。尽管需要进一步研究，但术前保持高水平身体活动可能会降低术后并发症的风险。
