Peri-operative patient optimization for oesophageal cancer surgery – From prehabilitation to enhanced recovery

The mortality from combined Epirubicin, Cisplatin and Capecitabine (ECX) chemotherapy was 1.8%, equivalent to the post-operative mortality seen in the trial [33]. [...]a diagnosis of cancer, and especially oesophageal cancer, results in a unique group of patients requiring an individualised or tailo...

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Bibliographic Details
Published in:Baillière's best practice & research. Clinical gastroenterology 2018-10, Vol.36-37, p.61-73
Main Authors: Zylstra, J., Boshier, P., Whyte, G.P., Low, D.E., Davies, A.R.
Format: Article
Language:English
Subjects:
Antibiotics
Cancer surgery
Cancer therapies
Cardiovascular disease
Chemotherapy
Colorectal cancer
Enhanced recovery after surgery
Esophageal cancer
Exercise
Marathons
Morbidity
Mortality
Muscle function
Oesophageal cancer
Patients
Physical fitness
Physiology
Pneumonia
Prehabilitation
Quality of life
Radiation therapy
Recovery (Medical)
Strength training
Surgery
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Summary:The mortality from combined Epirubicin, Cisplatin and Capecitabine (ECX) chemotherapy was 1.8%, equivalent to the post-operative mortality seen in the trial [33]. [...]a diagnosis of cancer, and especially oesophageal cancer, results in a unique group of patients requiring an individualised or tailored approach to prehabilitation. [...]prehabilitation to improve physical capacity is of greater importance in older patients and likely to become increasingly important as activity levels in the general population continues to fall [49].Provide interventions to promote the physical and psychological health of the patient that reduce the incidence and severity of future impairments Macmillan Cancer Support [50] encourage the World Health Organisation guideline of Activity in Healthy Adults [51]. Dr Nick Cavill, a health promotion consultant said: “If exercise were a pill, it would be one of the most cost-effective drugs ever invented”. [...]the challenge to those making clinical decisions in cancer care is to develop a greater understanding of exercise prehabilitation and its active promotion as an integral part of the treatment pathway. [...]minimization of driving pressure as well as limiting the duration of one lung ventilation should be clear objectives in preventing lung injury during oesophagectomy.
ISSN:1521-6918
1532-1916
DOI:10.1016/j.bpg.2018.11.006