ObjectiveTo systematically evaluate the risk factors forpersistent cough after pneumonectomy and to provide a theoretical basis for the prevention of persistent cough after surgery. MethodsResearches on risk factors of persistent cough after pneumonectomy were retrieved from The Cochrane Library, Web of Science, Embase, PubMed, CBM, Wanfang, CNKI and VIP from inception to March 30, 2023. Two researchers screened the literature, extracted data, and conducted quality evaluation. Meta-analysis was performed using RevMan 5.3 software. ResultsSeventeen studies with a total of 3 698 patients were finally included. Meta-analysis results showed that: female [OR=3.10, 95%CI (1.99, 4.81), P<0.001], age<63 years [OR=1.72, 95%CI (1.33, 2.21), P<0.001], right lung surgery [OR=2.36, 95%CI(1.80, 3.10), P<0.001], lobectomy [OR=3.40, 95%CI (2.47, 4.68), P<0.001], upper lobectomy [OR=8.19, 95%CI (3.87, 17.36)], lymph node dissection [OR=3.59, 95%CI(2.72, 4.72), P<0.001], bronchial stump approach [OR=5.19, 95%CI(1.79, 16.07), P=0.002], and postoperative acid reflux [OR=6.24, 95%CI(3.27, 11.91), P<0.001] were all risk factors for persistent cough after pneumonectomy (P<0.05). Smoking history [OR=0.59, 95%CI(0.45, 0.77), , P<0.001] was a protective factor for postoperative cough. In addition, the quality of life score (LCQ-MC) of patients with cough after surgery was lower than that before surgery [MD=1.50, 95%CI(0.14,2.86), P=0.03]. ConclusionAvailable evidence suggests that female, age <63 years, right lung surgery, lobectomy, lymph node dissection, bronchial stump approach (suture clamp closure), and postoperative acid reflux are independent risk factors for persistent postoperative cough in patients undergoing lung resection, while smoking history may be a protective factor forpostoperative cough. It provides an evidence-based evidence for clinical medical staff to prevent and reduce postoperative persistent cough and improve the quality of life of patients in the future.
ObjectiveTo longitudinally investigate the characteristics of postoperative weight changes in patients with esophageal cancer and analyze its influencing factors, which can provide certain guidance for nutritional intervention in patients with esophageal cancer. MethodsPatients with esophageal cancer who underwent surgical treatment at the Sichuan Cancer Hospital from December 2020 to February 2022 were prospectively included. The general information questionnaire and body composition analyzer were used to longitudinally investigate the patients’ weight and body composition before surgery (T0), 1 month after surgery (T1), 3 months after surgery (T2) and 6 months after surgery (T3), and the change characteristics were analyzed. The generalized estimating equation was used to analyze the influencing factors for postoperative weight changes in patients with esophageal cancer. ResultsA total of 130 patients were enrolled, including 110 males and 20 females, aged 42-79 (63.33±8.16) years. The weight and body composition of patients with esophageal cancer showed a continuous slow downward trend within 6 months after surgery. The weight loss rate of patients at 1, 3, and 6 months after surgery was 5.10%, 7.76%, and 9.86%, respectively. At the same time, the analysis results of the influencing factors for postoperative weight showed that patients with the following characteristics had more weight loss: female (β=−7.703, P=0.001), ≥60 years (β=−3.657, P=0.010), smoking (β=4.622, P=0.010), low tumor differentiation degree (β=4.314, P=0.039), and high frequency of eating (β=−3.400, P=0.008). ConclusionWeight loss is an important health problem for patients with esophageal cancer after surgery, and patients have a continuous downward trend in weight within 6 months after surgery. Medical staff should pay special attention to the patients who are female, ≥60 years, having smoking history and low tumor differentiation degree.
Objective To investigate the post-discharge exercise behavior and factors influencing moderate to vigorous intensity physical activity (MVPA) in patients undergoing lung surgery. Methods A survey was conducted using the Investigation of Exercise Behavior after Lung Surgery questionnaire and the International Physical Activity Questionnaire Short Form (IPAQ-SF) among patients who underwent lung surgery. Binary logistic regression was used to analyze the factors influencing patients’ engagement in MVPA. Results A total of 702 patients were surveyed, including 252 males and 450 females, with an average age of 52.4±10.2 years. Patients with lung cancer accounted for 85.9%. Only 36.0% of the patients had regular exercise habits, while 42.3% did not engage in any physical activity. The three main barriers were physical discomfort (pain, coughing, shortness of breath, etc, 54.7%), lack of professional guidance (41.7%), and concerns about the surgical wound (28.9%). The proportions of patients engaging in vigorous, moderate, and low-intensity physical activity were 5.7%, 28.2%, and 66.1%, respectively. Multivariate analysis showed that patients with a personal annual income ≥50000 yuan (OR=1.52, 95%CI 1.01-2.29, P=0.044), high school education or above (OR=1.92, 95%CI 1.33-2.76, P<0.001), and lobectomy (OR=1.44, 95%CI 1.02-2.03, P=0.037) engaged in more MVPA. Conclusion Patients undergoing lung surgery have inadequate physical activity after discharge, particularly lacking in MVPA. Patients with higher income, higher educational levels, and lobectomy are more frequently engaged in MVPA. Measures such as symptom control, providing exercise guidance, and enhancing education on wound care may potentially improve the inadequate physical activity in lung surgery patients after discharge.