Zhang Si-Wen, Wu Lei-Lei, Yang Hong, Li Chuan-Zhen, Wei Wei-Jin, Wang Min, Ma Guo-Wei, Zhong Jiu-Di
The Department of Thoracic Surgery, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.
Department of Thoracic Surgery, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, China.
Front Surg. 2021 Oct 15;8:735947. doi: 10.3389/fsurg.2021.735947. eCollection 2021.
The effect of active cycle of breathing technique (ACBT) on EC patients has not been well elucidated. In this research, we aim to explore the effect of ACBT on the perioperative outcomes in patients with esophageal carcinoma who underwent esophagectomy. Patients who underwent esophagectomy in an academic institution from December 2017 to July 2019 were included in this study. In a quasi-experimental study, participants were randomly divided into an experimental group (active cycle of breathing technique, = 107) and an observational group ( = 106) by drawing lots. The chi-squared test, Cochran-Mantel-Haenszel test, Logistic regression analysis, and Kruskal-Wallis test were used to analyze data. A two-sided value <0.05 was considered statistically significant. The primary observational endpoint was the mean weight of the sputum. Other outcomes included the six-min-walk test (6MWT), Borg scale, anastomotic leakage, and the length of hospital stay. 95 patients underwent minimally invasive surgery, and 118 patients received open surgery. There were 16 patients with anastomotic leakage in the present study, and we found that patients in the observational group had higher odds of anastomotic leakage. The results showed that the mean weight of the sputum in the observation group was lighter than that of the experimental group. After esophagectomy, the experimental group had better outcomes than the observation group (Borg scale: 2.448 vs. 1.547; 6-MWT: 372.811 vs. 425.355m, all < 0.05). The mean length of hospital stay was longer in the observation group (17.953 days) than that in the experimental group (12.037 days, = 0.01). We also found that the observational group had a higher discharge ratio over 2 weeks in all cohort (adjusted OR 2.487, 95% confidence intervals 1.147-5.392, = 0.021). Active cycle of breathing technique may improve the perioperative outcomes and decrease the length of hospital stay after surgery in patients with esophageal cancer. However, we need more researches to validate these findings.
呼吸训练主动循环技术(ACBT)对食管癌患者的影响尚未得到充分阐明。在本研究中,我们旨在探讨ACBT对接受食管切除术的食管癌患者围手术期结局的影响。纳入了2017年12月至2019年7月在一家学术机构接受食管切除术的患者。在一项准实验研究中,通过抽签将参与者随机分为实验组(呼吸训练主动循环技术,n = 107)和观察组(n = 106)。采用卡方检验、 Cochr an - Mantel - Haenszel检验、逻辑回归分析和Kruskal - Wallis检验进行数据分析。双侧P值<0.05被认为具有统计学意义。主要观察终点是痰液的平均重量。其他结局包括六分钟步行试验(6MWT)、Borg量表、吻合口漏和住院时间。95例患者接受了微创手术,118例患者接受了开放手术。本研究中有16例吻合口漏患者,我们发现观察组发生吻合口漏的几率更高。结果显示,观察组痰液的平均重量比实验组轻。食管切除术后,实验组的结局优于观察组(Borg量表:2.448对1.547;6 - MWT:372.811对425.355m,均P < 0.05)。观察组的平均住院时间(17.953天)比实验组(12.037天,P = 0.01)长。我们还发现,在所有队列中,观察组超过2周的出院率更高(调整后的OR为2.487,95%置信区间为1.147 - 5.392,P = 0.021)。呼吸训练主动循环技术可能改善食管癌患者的围手术期结局并缩短术后住院时间。然而,我们需要更多研究来验证这些发现。