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Journal of Gastrointestinal Surgery
Published in: Journal of Gastrointestinal Surgery 11/2020

01-11-2020 | Esophagus Resection | Review Article

Cardiopulmonary Exercise Testing in Oesophagogastric Surgery: a Systematic Review

Authors: G. Sheill, S. Reynolds, L. O’Neill, D. Mockler, J. V. Reynolds, J. Hussey, E. Guinan

Published in: Journal of Gastrointestinal Surgery | Issue 11/2020

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Abstract

Background

Cardiopulmonary exercise testing (CPX) can objectively measure fitness and oxygen uptake at anaerobic threshold. The relationship between fitness and postoperative outcomes after upper gastro-intestinal surgery is unclear. The aim of the present review is to assess the prognostic ability of CPX in predicting postoperative outcome associated with oesophagogastric surgery.

Methods

Relevant studies were identified through a systematic search of EMBASE, Medline, CINAHL, Cochrane Library, and Web of Science to July 2019. The eligibility criteria for studies included prognostic studies of upper gastro-intestinal surgery among adult populations using a preoperative CPX and measurement of postoperative outcome (mortality or morbidity or length of stay). Risk of bias was assessed using the QUIPS Quality in Prognostic Studies validated tool.

Results

Thirteen papers with a total of 1735 participants were included in data extraction. A total of 7 studies examined the association between CPX variables and postoperative mortality. Patients undergoing gastro-intestinal surgery with lower anaerobic threshold values were found to have an increased risk of postoperative mortality. Similarly, a lower rate of oxygen consumption was found to be associated with higher mortality. There was conflicting evidence regarding the association between CPX variables and postoperative morbidity. The evidence did not demonstrate any association between preoperative CPX variables and hospital length of stay.

Conclusion

Studies report an association between CPX variables and postoperative mortality; however, there is conflicting evidence regarding the association between CPX variables and postoperative morbidity.
Appendix
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Metadata
Title
Cardiopulmonary Exercise Testing in Oesophagogastric Surgery: a Systematic Review
Authors
G. Sheill
S. Reynolds
L. O’Neill
D. Mockler
J. V. Reynolds
J. Hussey
E. Guinan
Publication date
01-11-2020
Publisher
Springer US
Published in
Journal of Gastrointestinal Surgery / Issue 11/2020
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI
https://doi.org/10.1007/s11605-020-04696-2

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