Chen Keqing, Yao Fei, Chen Xiaoyu, Lin Yanjuan, Kang Minqiang
Department of Thoracic Surgery, Union Hospital, Fujian Medical University, Fuzhou, China.
Department of endocrinology, Fuzhou Hospital of Traditional Chinese Medicine, Fuzhou, China.
J Gastrointest Oncol. 2021 Aug;12(4):1255-1264. doi: 10.21037/jgo-21-385.
The occurrence of postoperative complications may lead to delayed recovery and a decline in physical function in the first 3 months after esophagectomy. The outbreak of COVID-19 imposed physical and emotional obstacles for traditional face-to-face rehabilitation. Meanwhile, the effectiveness of telerehabilitation remained unknown. In this study, we aimed to investigate the effectiveness of telerehabilitation.
A cohort of 86 patients who received minimally invasive esophagectomy between September 2020 and January 2021 was randomly allocated into two groups. The telerehabilitation group received additional online consulting and training, including (I) precautions for nutritional support; (II) swallowing function training; (III) respiratory function training; (IV) guidance and feedback on matters such as patient's current vital signs, wound status, medication, and sleep status. The primary outcome was the change of quality of life (QOL) of each patient at 3 months after surgery.
No serious adverse events were observed in either group. The telerehabilitation group showed significant improvements in pain using the OLQ-C30 scale (P<0.001), and in choking using the QLQ-OES18 scale (P<0.001). The comparison of the QLQ-C30 and QES-18 score changes at three months after discharge revealed that nearly all aspects in the telerehabilitation group displayed more score changes with significant changes in the appetite loss and pain part (P<0.001 and P<0.05, respectively). The score changes in QLQ-OES18 revealed significant improvement in swallowing saliva (P<0.05), as well slight improvements in choking, dry mouth, taste, and cough without significance.
Our study demonstrated that telerehabilitation was at least an important supplement to traditional face-to-face consulting and training for patients after esophageal cancer surgery during the COVID-19 period.
Chinese Clinical Trial Registry ChiCTR2100049186.
术后并发症的发生可能导致食管癌切除术后头3个月恢复延迟和身体功能下降。新型冠状病毒肺炎（COVID-19）的爆发给传统的面对面康复带来了身体和情感上的障碍。同时，远程康复的有效性尚不清楚。在本研究中，我们旨在调查远程康复的有效性。
将2020年9月至2021年1月期间接受微创食管癌切除术的86例患者随机分为两组。远程康复组接受额外的在线咨询和培训，包括：（I）营养支持注意事项；（II）吞咽功能训练；（III）呼吸功能训练；（IV）关于患者当前生命体征、伤口状况、用药和睡眠状况等事项的指导和反馈。主要结局是术后3个月时每位患者的生活质量（QOL）变化。
两组均未观察到严重不良事件。远程康复组在使用OLQ-C30量表评估的疼痛方面（P<0.001）以及使用QLQ-OES18量表评估的呛咳方面（P<0.001）有显著改善。出院后3个月时QLQ-C30和QES-18评分变化的比较显示，远程康复组几乎所有方面的评分变化更大，在食欲减退和疼痛部分有显著变化（分别为P<0.001和P<0.05）。QLQ-OES18的评分变化显示唾液吞咽方面有显著改善（P<0.05），在呛咳、口干、味觉和咳嗽方面有轻微改善但无统计学意义。
我们的研究表明，在COVID-疫情期间，远程康复至少是食管癌手术后患者传统面对面咨询和培训的重要补充。
中国临床试验注册中心ChiCTR2100049186
