Effect of Multidisciplinary Team Approach on Prevention of Postoperative Pulmonary Complications in Patients with Esophageal Cancer

Junichiro Inoue, Rei Ono, Daisuke Makiura, Miyuki Kashiwa-Motoyama, Tetsu Nakamura, Tatsuya Imanishi, Yasushi Miura, Yoshitada Sakai


AIM: This study aimed to investigate the possible prevention of postoperative pulmonary complications (PPCs) by introduction of multidisciplinary team (MDT) approach in esophageal cancer patients who underwent esophagectomy. METHODS: The retrospective cohort study of 132 esophageal cancer patients in a 900-bed university academic hospital between April 2008 and May 2011. The subjects included 120 patients who underwent esophagectomy. They were divided into two groups: 46 patients in the MDT approach group (MDT group) and 74 patients in the non-MDT approach group (NMDT group). RESULTS: The results demonstrated that the rates of PPCs were 4.3% and 16.2% in the MDT group and NMDT group, respectively. After the logistic regression analysis and multivariate analysis for correction of all considerable confounding factors, the MDT group demonstrated a significantly lesser incidence rate of PPCs than the NMDT group (OR: 0.16, 95% confidential interval: 0.02-0.75). CONCLUSION: This study revealed that the MDT approach reduced the occurrence of PPCs in esophageal cancer patients who underwent esophagectomy. The adequate perioperative management and considerable early rehabilitation and mobilization with risk management should be provided to prevent PPCs.


Esophagectomy; Multidisciplinary team approach; Postoperative pulmonary complications; Early mobilization; Respiratory rehabilitation

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