Akiyama Yuji, Iwaya Takeshi, Endo Fumitaka, Shioi Yoshihiro, Kumagai Motoi, Takahara Takeshi, Otsuka Koki, Nitta Hiroyuki, Koeda Keisuke, Mizuno Masaru, Kimura Yusuke, Suzuki Kenji, Sasaki Akira
Department of Surgery, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka, Iwate, 020-8505, Japan.
Department of Anesthesiology, Iwate Medical University School of Medicine, Iwate, Japan.
Support Care Cancer. 2017 Dec;25(12):3733-3739. doi: 10.1007/s00520-017-3801-x. Epub 2017 Jun 28.
We aimed to evaluate the effectiveness of intervention by a perioperative multidisciplinary support team for radical esophagectomy for esophageal cancer.
We retrospectively reviewed 85 consecutive patients with esophageal cancer who underwent radical esophagectomy via right thoracotomy or thoracoscopic surgery with gastric tube reconstruction. Twenty-one patients were enrolled in the non-intervention group (group N) from May 2011 to September 2012, 31 patients in the perioperative rehabilitation group (group R) from October 2012 to April 2014, and 33 patients in the multidisciplinary support team group (group S) from May 2014 to September 2015.
Morbidity rates were 38, 45.2, and 42.4% for groups N, R, and S, respectively. Although there were no significant differences in the incidence of pneumonia among the groups, the durations of fever and C-reactive protein positivity were shorter in group S. Moreover, postoperative oral intake commenced earlier [5.9 (5-8) days] and postoperative hospital stay was shorter [19.6 (13-29) days] for group S.
The intervention by a perioperative multidisciplinary support team for radical esophagectomy was effective in preventing the progression and prolongation of pneumonia as well as earlier ambulation, oral feeding, and shortening of postoperative hospitalization.
我们旨在评估围手术期多学科支持团队对食管癌根治性食管切除术的干预效果。
我们回顾性分析了85例连续接受经右胸开胸或胸腔镜手术并采用胃管重建的食管癌根治性食管切除术患者。2011年5月至2012年9月期间的21例患者纳入非干预组(N组),2012年10月至2014年4月期间的31例患者纳入围手术期康复组(R组),2014年5月至2015年9月期间的33例患者纳入多学科支持团队组(S组)。
N组、R组和S组的发病率分别为38%、45.2%和42.4%。尽管各组间肺炎发生率无显著差异,但S组的发热持续时间和C反应蛋白阳性持续时间较短。此外,S组术后开始经口进食时间更早[5.9(5 - 8)天],术后住院时间更短[19.6(13 - 29)天]。
围手术期多学科支持团队对根治性食管切除术的干预在预防肺炎进展和延长病程以及促进早期下床活动、经口进食和缩短术后住院时间方面是有效的。