The Prospective Study to Evaluate the Effect of Preoperative Cardiopulmonary Function Reinforcement Training for Patients with Esophageal Cancer

Yumi Koike¹⁾²⁾, Makoto Iwahashi¹⁾, Mikihito Nakamori¹⁾, Masaki Nakamura¹⁾, Teiji Naka¹⁾, Toshiyasu Ojima¹⁾, Masahiro Katsuda¹⁾, Takeshi Iida¹⁾, Fumihiro Tajima²⁾ and Hiroki Yamaue¹⁾

Second Department of Surgery¹⁾ and Department of Rehabilitation²⁾, School of Medicine, Wakayama Medical University

Purpose: We prospectively studied whether preoperative cardiopulmonary function reinforcement training improved maximum oxygen uptake per minute (VO₂max) and the training effect on psychological surgical stress in patients with esophageal cancer. Methods: Subjects were 23 patients with esophageal cancer undergoing curative esophagectomy with two- or three-field lymph node dissection via right thoracotomy. Preoperative cardiopulmonary function reinforcement training was conducted at 50-70% maximum heart rate reserved using a bicycle ergometer. We evaluated VO₂max, pulmonary spirometry and right lower-limb muscular strength before and after training. Using the state-trait anxiety inventory (STAI) questionnaire, we also evaluated trait and state anxiety. Results: Preoperative cardiopulmonary function reinforcement training significantly improved VO₂max and lower-limb muscular strength (p<0.05). Anxiety scores decreased (65.2%) after training, although trait anxiety scores did not change. First independent sitting, standing and postoperative walking were earlier than that in the control group (p<0.05). Conclusions: Results suggest that preoperative cardiopulmonary function reinforcement training improves VO₂max, pulmonary function, and lower-limb muscular strength while decreasing preoperative anxiety. Such preoperative training may thus help reduce pulmonary complications following esophagectomy for esophageal cancer.

Key words
esophageal cancer, VO₂max, cardiopulmonary complication, STAI

Reprint requests
Makoto Iwahashi Second Department of Surgery, School of Medicine, Wakayama Medical University
811-1 Kimiidera, Wakayama, 641-8510 JAPAN

Accepted
October 28, 2009

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