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Erschienen in: Supportive Care in Cancer 12/2017

28.06.2017 | Original Article

Effectiveness of intervention with a perioperative multidisciplinary support team for radical esophagectomy

verfasst von: Yuji Akiyama, Takeshi Iwaya, Fumitaka Endo, Yoshihiro Shioi, Motoi Kumagai, Takeshi Takahara, Koki Otsuka, Hiroyuki Nitta, Keisuke Koeda, Masaru Mizuno, Yusuke Kimura, Kenji Suzuki, Akira Sasaki

Erschienen in: Supportive Care in Cancer | Ausgabe 12/2017

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Abstract

Purpose

We aimed to evaluate the effectiveness of intervention by a perioperative multidisciplinary support team for radical esophagectomy for esophageal cancer.

Methods

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.

Results

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.

Conclusions

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.
Literatur
1.
Zurück zum Zitat Jafari MD, Halabi WJ, Smith BR, Nguyen VQ, Phelan MJ, Stamos MJ, Nguyen NT (2013) A decade analysis of trends and outcomes of partial versus total esophagectomy in the United States. Ann Surg 258:450–458CrossRefPubMed Jafari MD, Halabi WJ, Smith BR, Nguyen VQ, Phelan MJ, Stamos MJ, Nguyen NT (2013) A decade analysis of trends and outcomes of partial versus total esophagectomy in the United States. Ann Surg 258:450–458CrossRefPubMed
2.
Zurück zum Zitat Takeuchi H, Miyata H, Gotoh M, Kitagawa Y, Baba H, Kimura W, Tomita N, Nakagoe T, Shimada M, Sugihara K, Mori M (2014) A risk model for esophagectomy using data of 5354 patients included in a Japanese nationwide web-based database. Ann Surg 260:259–266CrossRefPubMed Takeuchi H, Miyata H, Gotoh M, Kitagawa Y, Baba H, Kimura W, Tomita N, Nakagoe T, Shimada M, Sugihara K, Mori M (2014) A risk model for esophagectomy using data of 5354 patients included in a Japanese nationwide web-based database. Ann Surg 260:259–266CrossRefPubMed
3.
Zurück zum Zitat Markar S, Gronnier C, Duhamel A, Bigourdan JM, Badic B, du Rieu MC, Lefevre JH, Turner K, Luc G, Mariette C (2015) Pattern of postoperative mortality after esophageal cancer resection according to center volume: results from a large European multicenter study. Ann Surg Oncol 22:2615–2623CrossRefPubMed Markar S, Gronnier C, Duhamel A, Bigourdan JM, Badic B, du Rieu MC, Lefevre JH, Turner K, Luc G, Mariette C (2015) Pattern of postoperative mortality after esophageal cancer resection according to center volume: results from a large European multicenter study. Ann Surg Oncol 22:2615–2623CrossRefPubMed
4.
Zurück zum Zitat Kataoka K, Takeuchi H, Mizusawa J, Igaki H, Ozawa S, Abe T, Nakamura K, Kato K, Ando N, Kitagawa Y (2016) Prognostic impact of postoperative morbidity after esophagectomy for esophageal cancer: exploratory analysis of JCOG9907. Ann Surg (Jun 8) [Epub ahead of print] Kataoka K, Takeuchi H, Mizusawa J, Igaki H, Ozawa S, Abe T, Nakamura K, Kato K, Ando N, Kitagawa Y (2016) Prognostic impact of postoperative morbidity after esophagectomy for esophageal cancer: exploratory analysis of JCOG9907. Ann Surg (Jun 8) [Epub ahead of print]
5.
Zurück zum Zitat Low DE, Alderson D, Cecconello I, Chang AC, Darling GE, DʼJourno XB, Griffin SM, Hölscher AH, Hofstetter WL, Jobe BA, Kitagawa Y, Kucharczuk JC, Law SY, Lerut TE, Maynard N, Pera M, Peters JH, Pramesh CS, Reynolds JV, Smithers BM, van Lanschot JJ (2015) International consensus on standardization of data collection for complications associated with esophagectomy: Esophagectomy Complications Consensus Group (ECCG). Ann Surg 262:286–294CrossRefPubMed Low DE, Alderson D, Cecconello I, Chang AC, Darling GE, DʼJourno XB, Griffin SM, Hölscher AH, Hofstetter WL, Jobe BA, Kitagawa Y, Kucharczuk JC, Law SY, Lerut TE, Maynard N, Pera M, Peters JH, Pramesh CS, Reynolds JV, Smithers BM, van Lanschot JJ (2015) International consensus on standardization of data collection for complications associated with esophagectomy: Esophagectomy Complications Consensus Group (ECCG). Ann Surg 262:286–294CrossRefPubMed
6.
Zurück zum Zitat Cao S, Zhao G, Cui J, Dong Q, Qi S, Xin Y, Shen B, Guo Q (2013) Fast-track rehabilitation program and conventional care after esophagectomy: a retrospective controlled cohort study. Support Care Cancer 21:707–714CrossRefPubMed Cao S, Zhao G, Cui J, Dong Q, Qi S, Xin Y, Shen B, Guo Q (2013) Fast-track rehabilitation program and conventional care after esophagectomy: a retrospective controlled cohort study. Support Care Cancer 21:707–714CrossRefPubMed
7.
Zurück zum Zitat Li C, Ferri LE, Mulder DS, Ncuti A, Neville A, Lee L, Kaneva P, Watson D, Vassiliou M, Carli F, Feldman LS (2012) An enhanced recovery pathway decreases duration of stay after esophagectomy. Surgery 152:606–614CrossRefPubMed Li C, Ferri LE, Mulder DS, Ncuti A, Neville A, Lee L, Kaneva P, Watson D, Vassiliou M, Carli F, Feldman LS (2012) An enhanced recovery pathway decreases duration of stay after esophagectomy. Surgery 152:606–614CrossRefPubMed
8.
Zurück zum Zitat Munitiz V, Martinez-de-Haro LF, Ortiz A, Ruiz-de-Angulo D, Pastor P, Parrilla P (2010) Effectiveness of a written clinical pathway for enhanced recovery after transthoracic (Ivor Lewis) oesophagectomy. Br J Surg 97:714–718CrossRefPubMed Munitiz V, Martinez-de-Haro LF, Ortiz A, Ruiz-de-Angulo D, Pastor P, Parrilla P (2010) Effectiveness of a written clinical pathway for enhanced recovery after transthoracic (Ivor Lewis) oesophagectomy. Br J Surg 97:714–718CrossRefPubMed
9.
Zurück zum Zitat Jiang K, Cheng L, Wang JJ, Li JS, Nie J (2009) Fast track clinical pathway implications in esophagogastrectomy. World J Gastroenterol 15:496–501CrossRefPubMedPubMedCentral Jiang K, Cheng L, Wang JJ, Li JS, Nie J (2009) Fast track clinical pathway implications in esophagogastrectomy. World J Gastroenterol 15:496–501CrossRefPubMedPubMedCentral
10.
Zurück zum Zitat Cerfolio RJ, Bryant AS, Bass CS, Alexander JR, Bartolucci AA (2004) Fast tracking after Ivor Lewis esophagogastrectomy. Chest 126:1187–1194CrossRefPubMed Cerfolio RJ, Bryant AS, Bass CS, Alexander JR, Bartolucci AA (2004) Fast tracking after Ivor Lewis esophagogastrectomy. Chest 126:1187–1194CrossRefPubMed
11.
Zurück zum Zitat Low DE, Kunz S, Schembre D, Otero H, Malpass T, Hsi A, Song G, Hinke R, Kozarek RA (2007) Esophagectomy—it’s not just about mortality anymore: standardized perioperative clinical pathways improve outcomes in patients with esophageal cancer. J Gastrointest Surg 11:1395–1402CrossRefPubMed Low DE, Kunz S, Schembre D, Otero H, Malpass T, Hsi A, Song G, Hinke R, Kozarek RA (2007) Esophagectomy—it’s not just about mortality anymore: standardized perioperative clinical pathways improve outcomes in patients with esophageal cancer. J Gastrointest Surg 11:1395–1402CrossRefPubMed
12.
Zurück zum Zitat Kehlet H, Wilmore DW (2008) Evidence-based surgical care and the evolution of fast-track surgery. Ann Surg 248:189–198CrossRefPubMed Kehlet H, Wilmore DW (2008) Evidence-based surgical care and the evolution of fast-track surgery. Ann Surg 248:189–198CrossRefPubMed
13.
Zurück zum Zitat Maessen J, Dejong CH, Hausel J, Nygren J, Lassen K, Andersen J, Kessels AG, Revhaug A, Kehlet H, Ljungqvist O, Fearon KC, von Meyenfeldt MF (2007) A protocol is not enough to implement an enhanced recovery programme for colorectal resection. Br J Surg 94:224–231CrossRefPubMed Maessen J, Dejong CH, Hausel J, Nygren J, Lassen K, Andersen J, Kessels AG, Revhaug A, Kehlet H, Ljungqvist O, Fearon KC, von Meyenfeldt MF (2007) A protocol is not enough to implement an enhanced recovery programme for colorectal resection. Br J Surg 94:224–231CrossRefPubMed
14.
Zurück zum Zitat Japan Esophageal Society (2015) Japanese classification of esophageal cancer, 11th edn. Kanehara, Tokyo Japan Esophageal Society (2015) Japanese classification of esophageal cancer, 11th edn. Kanehara, Tokyo
15.
Zurück zum Zitat Kuwano H, Nishimura Y, Oyama T, Kato H, Kitagawa Y, Kusano M, Shimada H, Takiuchi H, Toh Y, Doki Y, Naomoto Y, Matsubara H, Miyazaki T, Muto M, Yanagisawa A (2015) Guidelines for diagnosis and treatment of carcinoma of the esophagus April 2012 edited by the Japan Esophageal Society. Esophagus 12:1–30CrossRefPubMed Kuwano H, Nishimura Y, Oyama T, Kato H, Kitagawa Y, Kusano M, Shimada H, Takiuchi H, Toh Y, Doki Y, Naomoto Y, Matsubara H, Miyazaki T, Muto M, Yanagisawa A (2015) Guidelines for diagnosis and treatment of carcinoma of the esophagus April 2012 edited by the Japan Esophageal Society. Esophagus 12:1–30CrossRefPubMed
16.
Zurück zum Zitat American Thoracic Society and Infectious Diseases Society of America (2005) Guidelines for the management of adults with hospital-acquired, ventilator-associated, and healthcare-associated pneumonia. Am J Respir Crit Care Med 171:388–416CrossRef American Thoracic Society and Infectious Diseases Society of America (2005) Guidelines for the management of adults with hospital-acquired, ventilator-associated, and healthcare-associated pneumonia. Am J Respir Crit Care Med 171:388–416CrossRef
17.
Zurück zum Zitat Feeney C, Hussey J, Carey M, Reynolds JV (2010) Assessment of physical fitness for esophageal surgery, and targeting interventions to optimize outcomes. Dis Esophagus 23:529–539CrossRefPubMed Feeney C, Hussey J, Carey M, Reynolds JV (2010) Assessment of physical fitness for esophageal surgery, and targeting interventions to optimize outcomes. Dis Esophagus 23:529–539CrossRefPubMed
18.
Zurück zum Zitat Hulzebos EH, Helders PJ, Favié NJ, De Bie RA, Brutel de la Riviere A, Van Meeteren NL (2006) Preoperative intensive inspiratory muscle training to prevent postoperative pulmonary complications in high-risk patients undergoing CABG surgery: a randomized clinical trial. JAMA 296:1851–1857CrossRefPubMed Hulzebos EH, Helders PJ, Favié NJ, De Bie RA, Brutel de la Riviere A, Van Meeteren NL (2006) Preoperative intensive inspiratory muscle training to prevent postoperative pulmonary complications in high-risk patients undergoing CABG surgery: a randomized clinical trial. JAMA 296:1851–1857CrossRefPubMed
19.
Zurück zum Zitat Algar FJ, Alvarez A, Salvatierra A, Baamonde C, Aranda JL, López-Pujol FJ (2003) Predicting pulmonary complications after pneumonectomy for lung cancer. Eur J Cardiothorac Surg 23:201–208CrossRefPubMed Algar FJ, Alvarez A, Salvatierra A, Baamonde C, Aranda JL, López-Pujol FJ (2003) Predicting pulmonary complications after pneumonectomy for lung cancer. Eur J Cardiothorac Surg 23:201–208CrossRefPubMed
20.
Zurück zum Zitat Dronkers J, Veldman A, Hoberg E, van der Waal C, van Meeteren N (2008) Prevention of pulmonary complications after upper abdominal surgery by preoperative intensive inspiratory muscle training: a randomized controlled pilot study. Clin Rehabil 22:134–142CrossRefPubMed Dronkers J, Veldman A, Hoberg E, van der Waal C, van Meeteren N (2008) Prevention of pulmonary complications after upper abdominal surgery by preoperative intensive inspiratory muscle training: a randomized controlled pilot study. Clin Rehabil 22:134–142CrossRefPubMed
21.
Zurück zum Zitat Lunardi AC, Cecconello I, Carvalho CR (2011) Postoperative chest physical therapy prevents respiratory complications in patients undergoing esophagectomy. Rev Bras Fisioter 15:160–165CrossRefPubMed Lunardi AC, Cecconello I, Carvalho CR (2011) Postoperative chest physical therapy prevents respiratory complications in patients undergoing esophagectomy. Rev Bras Fisioter 15:160–165CrossRefPubMed
22.
Zurück zum Zitat Ito N, Iwaya T, Ikeda K, Kimura Y, Akiyama Y, Konosu M, Ishida K, Fujiwara H, Otsuka K, Nitta H, Kashiwaba M, Koeda K, Nishizuka S, Mizuno M, Sasaki A, Wakabayashi G (2014) Hyperglycemia 3 days after esophageal cancer surgery is associated with an increased risk of postoperative infection. J Gastrointest Surg 18:1547–1556CrossRefPubMed Ito N, Iwaya T, Ikeda K, Kimura Y, Akiyama Y, Konosu M, Ishida K, Fujiwara H, Otsuka K, Nitta H, Kashiwaba M, Koeda K, Nishizuka S, Mizuno M, Sasaki A, Wakabayashi G (2014) Hyperglycemia 3 days after esophageal cancer surgery is associated with an increased risk of postoperative infection. J Gastrointest Surg 18:1547–1556CrossRefPubMed
Metadaten
Titel
Effectiveness of intervention with a perioperative multidisciplinary support team for radical esophagectomy
verfasst von
Yuji Akiyama
Takeshi Iwaya
Fumitaka Endo
Yoshihiro Shioi
Motoi Kumagai
Takeshi Takahara
Koki Otsuka
Hiroyuki Nitta
Keisuke Koeda
Masaru Mizuno
Yusuke Kimura
Kenji Suzuki
Akira Sasaki
Publikationsdatum
28.06.2017
Verlag
Springer Berlin Heidelberg
Erschienen in
Supportive Care in Cancer / Ausgabe 12/2017
Print ISSN: 0941-4355
Elektronische ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-017-3801-x

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