title: Randomized Controlled Study to Evaluate the Efficacy of a Preoperative Respiratory Rehabilitation Program to Prevent Postoperative Pulmonary Complications after Esophagectomy.
abstract: OBJECTIVE
  Patients with postoperative pulmonary complications after esophagectomy often have increased mortality. The purpose of the study was to examine the efficacy of preventing postoperative pulmonary complications by an intensive preoperative respiratory rehabilitation (PR) program for esophageal cancer patients.
  
  
  METHODS
  This study was a prospective randomized controlled study. Thirty patients in the PR group and 30 patients in the no preoperative respiratory rehabilitation (NPR) group were included. The PR group received preoperative rehabilitation for more than 7 days, while the NPR group did not receive any preoperative rehabilitation. All patients underwent postoperative rehabilitation from the first postoperative day. The postoperative pulmonary complications were evaluated using the Clavien-Dindo classification (CDC) and the Utrecht Pneumonia Scoring System (UPSS).
  
  
  RESULTS
  The CDC grade in the PR group was significantly lower than that in the NPR group (p = 0.014). The UPSS score in the PR group was significantly lower than that in the NPR group at postoperative day 1 (p = 0.031). In the multivariate analysis, NPR was an independent risk factor for postoperative pulmonary complications greater than CDC grade II (OR: 3.99, 95% CI: 1.28-12.4, p = 0.017).
  
  
  CONCLUSIONS
  This study showed that the intensive PR program was capable of reducing the postoperative pulmonary complications in esophageal cancer patients.
authors.affiliation: Department of Gastroenterological Surgery, Fukuoka University Faculty of Medicine, Nanakuma, Jonan-ku, Fukuoka, Japan.
authors.forename: Ippei
authors.initials: I
authors.lastname: Yamana
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Takeno
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Hashimoto
authors.forename: Kenji
authors.initials: K
authors.lastname: Maki
authors.forename: Ryosuke
authors.initials: R
authors.lastname: Shibata
authors.forename: Hironari
authors.initials: H
authors.lastname: Shiwaku
authors.forename: Hideki
authors.initials: H
authors.lastname: Shimaoka
authors.forename: Etsuji
authors.initials: E
authors.lastname: Shiota
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Yamashita
mesh_terms: D000328:Adult; D000368:Aged; D004938:Esophageal Neoplasms / Q000601:surgery*; D016629:Esophagectomy; D005260:Female; D006801:Humans; D008171:Lung Diseases / Q000209:etiology / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control*; D011300:Preoperative Care / Q000379:methods*; D011446:Prospective Studies; D012138:Respiratory Therapy / Q000379:methods*; D012307:Risk Factors; D016896:Treatment Outcome