Effect of early mobilization on postoperative pulmonary complications in patients undergoing video-assisted thoracoscopic surgery on the esophagus.

Publisher: Springer Country of Publication: Japan NLM ID: 101206627 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1612-9067 (Electronic) Linking ISSN: 16129059 NLM ISO Abbreviation: Esophagus Subsets: MEDLINE

Original Publication: Tokyo, Japan : Springer, [2003]-

Early Ambulation*; Esophageal Neoplasms/*surgery ; Esophagectomy/*adverse effects ; Pulmonary Atelectasis/*etiology ; Thoracic Surgery, Video-Assisted/*adverse effects; Activities of Daily Living ; Aged ; Esophagectomy/methods ; Female ; Humans ; Male ; Middle Aged ; Physical Therapy Modalities ; Postoperative Care ; Postoperative Complications/etiology ; Postoperative Complications/prevention & control ; Preoperative Care ; Pulmonary Atelectasis/prevention & control ; Retrospective Studies ; Walking/physiology

Background: Esophagectomy performed via thoracotomy is associated with a high rate of postoperative pulmonary complications. Video-assisted thoracoscopic surgery at the esophagus (VATS-E) can reduce the rate of postoperative pulmonary complications. VATS-E is being increasingly implemented owing to its benefits. This procedure makes early patient mobilization possible, because there is minimal thoracic wall invasion, and thus, less postoperative pain. This study aimed to identify the efficacy of early mobilization in patients undergoing VATS-E.
Methods: We retrospectively reviewed the patients who underwent VATS-E between November 2008 and October 2016. All the patients underwent preoperative physiotherapy and postoperative early mobilization for standard perioperative management. We examined the relation between early mobilization and the factors affecting postoperative pulmonary complications and the duration of physiotherapy with regard to the surgical outcome of VATS-E.
Results: A total of 118 patients who underwent VATS-E were assessed. The incidence of postoperative pulmonary atelectasis decreased with early mobilization, and earlier mobilization was associated with a better decrease (P < 0.001). Multiple logistic regression analysis identified the percentage of volume capacity [odds ratio (OR) 0.96; 95% confidence interval (CI) 0.93-0.99] and initial walking (OR 1.82; 95% CI 1.40-2.48) as independent risk factors for postoperative pulmonary atelectasis. In addition, the presence or absence of atelectasis was found to reduce the necessary period of physiotherapy (P < 0.001).
Conclusion: Our results indicated that early mobilization reduces the incidence of postoperative pulmonary atelectasis, which may also contribute to early recovery in patients who undergo VATS-E.

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Keywords: Early mobilization; Esophageal cancer; Physiotherapy; Postoperative pulmonary complications; Thoracoscopic esophagectomy

Date Created: 20180613 Date Completed: 20181220 Latest Revision: 20181220

20240829

10.1007/s10388-017-0600-x

29892929