Please use this identifier to cite or link to this item: http://hdl.handle.net/11434/1547
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dc.contributor.authorLee, Angus-
dc.contributor.authorHeriot, Alexander-
dc.contributor.otherKong, J.-
dc.contributor.otherIsmail, H.-
dc.contributor.otherRiedel, B.-
dc.date.accessioned2018-10-31T03:17:19Z-
dc.date.available2018-10-31T03:17:19Z-
dc.date.issued2018-03-
dc.identifier.citationDis Colon Rectum. 2018 Mar;61(3):400-409.en_US
dc.identifier.issn0012-3706en_US
dc.identifier.issn1530-0358en_US
dc.identifier.urihttp://hdl.handle.net/11434/1547-
dc.description.abstractBACKGROUND: Gas exchange-derived variables obtained from cardiopulmonary exercise testing allow objective assessment of functional capacity and hence physiological reserve to withstand the stressors of major surgery. Field walk tests provide an alternate means for objective assessment of functional capacity that may be cheaper and have greater acceptability, in particular, in elderly patients. OBJECTIVE: This systematic review evaluated the predictive value of cardiopulmonary exercise testing and field walk tests in surgical outcomes after colorectal surgery. DATA SOURCE: A systematic search was undertaken using Medline, PubMed, Embase, CINAHL, and PEDro. STUDY SELECTION: Adult patients who had cardiopulmonary exercise testing and/or field walk test before colorectal surgery were included. MAIN OUTCOME MEASURE: The primary outcomes measured were hospital length of stay and postoperative morbidity and mortality. RESULTS: A total of 7 studies with a cohort of 1418 patients who underwent colorectal surgery were identified for inclusion in a qualitative analysis. Both pooled oxygen consumption at anaerobic threshold (range, 10.1-11.1 mL·kg·min) and peak oxygen consumption (range, 16.7-18.6 mL·kg·min) were predictive of complications (OR for anaerobic threshold, 0.76; 95% CI, 0.66-0.85, p<0.0001; OR for peak oxygen consumption, 0.76; 95% CI, 0.67-0.85, p<0.0001). Patients had significant increased risk of developing postoperative complications if their anaerobic threshold was below this cut point (p<0.001). However, it was not predictive of anastomotic leak (p = 0.644). Shorter distance (<250 m) walked in incremental shuttle walk test, lower anaerobic threshold, and lower peak oxygen consumption were associated with prolonged hospital length of stay, which was closely related to the development of complications. CONCLUSIONS: Variables derived from cardiopulmonary exercise testing are predictive of postoperative complications and hospital length of stay. Currently, there are insufficient data to support the predictive role of the field walk test in colorectal surgery.en_US
dc.publisherLWWen_US
dc.subjectCardiopulmonary Exercisesen_US
dc.subjectObjective Assessment of Functional Capacityen_US
dc.subjectPhysiological Reserveen_US
dc.subjectStressorsen_US
dc.subjectMajor Surgeryen_US
dc.subjectField Walk Testsen_US
dc.subjectGreater Acceptabilityen_US
dc.subjectElderly Patientsen_US
dc.subjectSystematic Reviewen_US
dc.subjectPredictive Valueen_US
dc.subjectColorectal Surgeryen_US
dc.subjectSurgical Outcomesen_US
dc.subjectHospital Length of Stayen_US
dc.subjectPostoperative Morbidityen_US
dc.subjectPostoperative Mortalityen_US
dc.subjectQualitative Analysisen_US
dc.subjectPooled Oxygen Consumptionen_US
dc.subjectAnaerobic Thresholden_US
dc.subjectPeak Oxygen Consumptionen_US
dc.subjectPredictive of Complicationsen_US
dc.subjectAnastomotic Leaken_US
dc.subjectIncremental Shuttle Walk Testen_US
dc.subjectDevelopment of Complicationsen_US
dc.subjectCardiopulmonary Exercise Testingen_US
dc.subjectGeneral Surgery and Gastroenterology Clinical Institute, Epworth HealthCare, Victoria, Australiaen_US
dc.subjectCancer Services Clinical Institute, Epworth HealthCare, Victoria, Australiaen_US
dc.titleSystematic review and meta-analysis of objective assessment of physical fitness in patients undergoing colorectal cancer surgery.en_US
dc.typeJournal Articleen_US
dc.identifier.doi10.1097/DCR.0000000000001017en_US
dc.identifier.journaltitleDiseases of the Colon & Rectumen_US
dc.description.pubmedurihttps://www.ncbi.nlm.nih.gov/pubmed/29377872en_US
dc.description.affiliatesDivision of Cancer Surgery, Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, Victoria, Australiaen_US
dc.description.affiliatesDepartment of Anaesthetics, Perioperative and Pain Medicine, Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, Victoria, Australia.en_US
dc.type.studyortrialMeta-Analysisen_US
dc.type.contenttypeTexten_US
Appears in Collections:Cancer Services
General Surgery and Gastroenterology

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