title: Postoperative chest physical therapy prevents respiratory complications in patients undergoing esophagectomy.
abstract: BACKGROUND
  Esophagectomy presents the highest rate of postoperative pulmonary complications among all types of upper abdominal surgery. The benefits of chest physical therapy in patients undergoing upper abdominal surgery have been shown by many studies; however, its specific effect in patients receiving esophagectomy has been seldom investigated.
  
  
  OBJECTIVE
  This study aimed to compare the frequency of respiratory complications in patients undergoing esophagectomy receiving chest physical therapy compared to no treatment.
  
  
  METHODS
  70 consecutive patients were evaluated retrospectively and allocated to two groups: control group (CG=no physical therapy; n=30) and chest physical therapy group (PTG; n=40). Patients received chest physical therapy which includes lung re-expansion and airway clearance maneuvers. They were not submitted to either noninvasive ventilation or exercises with devices that generate airways positive pressure. All patients were instructed to early mobilization. Information about pre-operative and respiratory complications were collected. Statistic analysis to compare the frequency of respiratory complications was performed by the Z test. The significance level was set to 5%.
  
  
  RESULTS
  Patients in the CG and PTG were similar in terms of age, BMI, smoking and drinking status, malignant diseases, surgical and anesthesia duration and types of esophagectomy (p>0.05). Our results show that patients received chest physical therapy after esophagectomy had a lower frequency of respiratory complications (15% vs. 37%, p<0.05). In addition, the PTG needed a shorter duration of antibiotic treatment and thoracic drainage as well as less re-intubation compared with the control group (p<0.05).
  
  
  CONCLUSIONS
  Our results suggest that chest physical therapy treatment reduces respiratory complications and the need for care but does not influence on hospital length of stay.
authors.affiliation: Physical Therapy Department, School of Medicine, Universidade de São Paulo, São Paulo, SP, Brazil.
authors.forename: Adriana C
authors.initials: AC
authors.lastname: Lunardi
authors.forename: Ivan
authors.initials: I
authors.lastname: Cecconello
authors.forename: Celso R F
authors.initials: CR
authors.lastname: Carvalho
mesh_terms: D016629:Esophagectomy / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D026741:Physical Therapy Modalities; D011182:Postoperative Care; D012120:Respiration Disorders / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control*; D012189:Retrospective Studies