Interventions targeting postoperative pulmonary complications (PPCs) in patients undergoing esophageal cancer surgery: a systematic review of randomized clinical trials and narrative discussion.
Ann-Marie DuffGerard LambeNoel E DonlonClaire L DonohoeAnne-Marie BradyJohn V ReynoldsPublished in: Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus (2022)
Postoperative pulmonary complications (PPCs) represent the most common complications after esophageal cancer surgery. The lack of a uniform reporting nomenclature and a severity classification has hampered consistency of research in this area, including the study of interventions targeting prevention and treatment of PPCs. This systematic review focused on RCTs of clinical interventions used to minimize the impact of PPCs. Searches were conducted up to 08/02/2021 on MEDLINE (OVID), CINAHL, Embase, Web of Science, and the COCHRANE library for RCTs and reported in accordance with PRISMA guidelines. A total of 339 citations, with a pooled dataset of 1,369 patients and 14 RCTs, were included. Heterogeneity of study design and outcomes prevented meta-analysis. PPCs are multi-faceted and not fully understood with respect to etiology. The review highlights the paucity of high-quality evidence for best practice in the management of PPCs. Further research in the area of intraoperative interventions and early postoperative ERAS standards is required. A consistent uniform for definition of pneumonia after esophagectomy and the development of a severity scale appears warranted to inform further RCTs and guidelines.
Keyphrases
- patients undergoing
- systematic review
- meta analyses
- physical activity
- minimally invasive
- coronary artery bypass
- pulmonary hypertension
- end stage renal disease
- newly diagnosed
- clinical practice
- cancer therapy
- public health
- randomized controlled trial
- ejection fraction
- primary care
- healthcare
- machine learning
- chronic kidney disease
- single cell
- prognostic factors
- type diabetes
- metabolic syndrome
- coronary artery disease
- weight loss
- drug delivery
- acute coronary syndrome
- study protocol
- smoking cessation
- glycemic control