Relationship between diaphragm function assessed by ultrasonography and postoperative pulmonary complication in patients after esophageal cancer surgery

2023 Fiscal Year Final Research Report

• Project/Area Number: 21K21245
• Research Category: Grant-in-Aid for Research Activity Start-up
• Allocation Type: Multi-year Fund
• Review Section: 0909:Sports sciences, physical education, health sciences, and related fields
• Research Institution: Akita University
• Principal Investigator: Okura Kazuki 秋田大学, 医学部附属病院, 理学療法士 (70910313)
• Project Period (FY): 2021-08-30 – 2024-03-31
• Keywords: 食道癌 / 食道切除再建術 / 術後呼吸器合併症 / 横隔膜 / 超音波画像解析

Outline of Final Research Achievements

The purpose of this study was to investigate whether the diaphragmatic function assessed using ultrasound imaging may be a new risk marker for postoperative pulmonary complications in patients with esophageal cancer who are scheduled for esophagectomy. The study included 70 patients with esophageal cancer. Pre- and postoperative diaphragmatic function was assessed using ultrasound imaging and showed a decrease in diaphragmatic function at 1 and 2 weeks postoperatively compared to preoperatively. Preoperative diaphragmatic function was associated with postoperative pulmonary complications such as sputum expectoration difficulty and pneumonia. Our results suggest that decreased diaphragmatic function is a risk factor for postoperative pulmonary complications.

Free Research Field

リハビリテーション医学

Academic Significance and Societal Importance of the Research Achievements

食道癌に対する根治的手術は頸部、胸部、腹部と複数の手術操作を要し高侵襲である。鏡視下手術およびロボット支援下手術の導入により低侵襲化は進んできたが、肺炎などの術後呼吸器合併症は未だ多い。呼吸器合併症を含む術後合併症は臨床転帰に直結するため、これらを回避することは重要である。本研究の結果から術前の横隔膜機能低下が術後呼吸器合併症に関連することが示唆された。横隔膜を含めた呼吸筋の筋力は改善可能な要因であり、術前の呼吸筋強化が良好な臨床転帰に寄与する可能性がある。