Association Between Early Mobilization and Postoperative Pneumonia Following Robot-assisted Minimally Invasive Esophagectomy in Patients with Thoracic Esophageal Squamous Cell Carcinoma

DOI 機関リポジトリ Web Site 参考文献36件
  • NOZAWA Yasuaki
    Division of Physical Medicine and Rehabilitation, Okayama University Hospital, Japan
  • HARADA Kazuhiro
    Graduate School of Health Science Studies, Kibi International University, Japan
  • NOMA Kazuhiro
    Department of Gastroenterological Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Japan
  • KATAYAMA Yoshimi
    Division of Physical Medicine and Rehabilitation, Okayama University Hospital, Japan
  • HAMADA Masanori
    Division of Physical Medicine and Rehabilitation, Okayama University Hospital, Japan
  • OZAKI Toshifumi
    Division of Physical Medicine and Rehabilitation, Okayama University Hospital, Japan

書誌事項

公開日
2024
資源種別
journal article
DOI
  • 10.1298/ptr.e10293
公開者
一般社団法人日本理学療法学会連合

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<p>Objective: The objective of this study was to confirm that early mobilization (EM) could reduce pneumonia in patients undergoing robot-assisted minimally invasive esophagectomy (RAMIE) for thoracic esophageal squamous cell carcinoma (TESCC). Methods: Postoperative pneumonia was defined as physician-diagnosed pneumonia using the Esophagectomy Complications Consensus Group definition of pneumonia with a Clavien–Dindo classification grade II–V on postoperative day (POD) 3–5. EM was defined as achieving an ICU Mobility Scale (IMS) ≥7 by POD 2. Patients were divided into EM (n = 36) and non-EM (n = 35) groups. Barriers to EM included pain, orthostatic intolerance (OI), and orthostatic hypotension. Results: The overall incidence of postoperative pneumonia was 12.7%, with a significant difference between the EM (2.8%) and non-EM (22.9%) groups (P = 0.014). The odds ratio was 0.098 in the EM group compared to the non-EM group. A significant difference was found between the two groups in terms of the barriers to EM at POD 2 only for OI, with a higher incidence in the non-EM group. Multivariate logistic regression analysis showed that patients with OI were more likely to be unable to achieve EM than those without OI (odds ratio, 7.030; P = 0.006). Conclusion: EM within POD 2 may reduce the incidence of postoperative pneumonia in patients undergoing RAMIE for TESCC. Furthermore, it was suggested that OI can have a negative impact on the EM after RAMIE.</p>

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