Imperial College London
Dr Sheraz Markar

DrSherazMarkar

Faculty of Medicine, Department of Surgery & Cancer

Honorary Clinical Senior Lecturer
 
 
 
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Contact

 

+44 (0)20 3312 7657s.markar

 
 
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Location

 

Queen Elizabeth the Queen Mother Wing (QEQM)St Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Tukanova:2021:10.1245/s10434-021-11122-7,
author = {Tukanova, K and Chidambaram, S and Guidozzi, N and Hanna, G and McGregor, A and Markar, S},
doi = {10.1245/s10434-021-11122-7},
journal = {Annals of Surgical Oncology},
title = {Physiotherapy regimens in esophagectomy and gastrectomy: a systematic review and meta-analysis},
url = {http://dx.doi.org/10.1245/s10434-021-11122-7},
volume = {29},
year = {2021}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BackgroundEsophageal and gastric cancer surgery are associated with considerable morbidity, specifically postoperative pulmonary complications (PPCs), potentially accentuated by underlying challenges with malnutrition and cachexia affecting respiratory muscle mass. Physiotherapy regimens aim to increase the respiratory muscle strength and may prevent postoperative morbidity.ObjectiveThe aim of this study was to assess the impact of physiotherapy regimens in patients treated with esophagectomy or gastrectomy.MethodsAn electronic database search was performed in the MEDLINE, EMBASE, CENTRAL, CINAHL and Pedro databases. A meta-analysis was performed to assess the impact of physiotherapy on the functional capacity, incidence of PPCs and postoperative morbidity, in-hospital mortality rate, length of hospital stay (LOS) and health-related quality of life (HRQoL).ResultsSeven randomized controlled trials (RCTs) and seven cohort studies assessing prehabilitation totaling 960 patients, and five RCTs and five cohort studies assessing peri- or postoperative physiotherapy with 703 total patients, were included. Prehabilitation resulted in a lower incidence of postoperative pneumonia and morbidity (Clavien–Dindo score ≥ II). No difference was observed in functional exercise capacity and in-hospital mortality following prehabilitation. Meanwhile, peri- or postoperative rehabilitation resulted in a lower incidence of pneumonia, shorter LOS, and better HRQoL scores for dyspnea and physical functioning, while no differences were found for the QoL summary score, global health status, fatigue, and pain scores.ConclusionThis meta-analysis suggests that implementing an exercise intervention may be beneficial in both the preoperative and peri- or postoperative periods. Further investigation is needed to understand the mechanism through which exercise interventions improve clinical outcomes and which patient subgroup will gain the maximal benefit.
AU  - Tukanova,K
AU  - Chidambaram,S
AU  - Guidozzi,N
AU  - Hanna,G
AU  - McGregor,A
AU  - Markar,S
DO  - 10.1245/s10434-021-11122-7
PY  - 2021///
SN  - 1068-9265
TI  - Physiotherapy regimens in esophagectomy and gastrectomy: a systematic review and meta-analysis
T2  - Annals of Surgical Oncology
UR  - http://dx.doi.org/10.1245/s10434-021-11122-7
UR  - http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000755788600230&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
UR  - https://link.springer.com/article/10.1245/s10434-021-11122-7
UR  - http://hdl.handle.net/10044/1/97458
VL  - 29
ER  -
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