Preoperative physical activity levels and postoperative pulmonary complications post-esophagectomy

Postoperative pulmonary complications (PPCs) after esophagectomy have been reported to occur in 15-30% of patients and are the most common causes of major morbidity and mortality. Risk factors for the development of PPCs include impairment in lung function, cardiac reserve, aerobic capacity, and body composition. Physical activity is associated with these factors but has not been examined in relation to the risk of developing a PPC. The aim of this cross-sectional study was to investigate if there was a difference in physical activity levels, lung function, and body composition in patients who developed a PPC post-esphagectomy compared with those who did not. Consecutive patients were studied preoperatively: (i) lung function with a portable micro-medical spirometer; (ii) body composition analysis using a Tanita BC 418 machine (Tanita Corp., Tokyo, Japan); and (iii) physical activity with an accelerometer (RT3, (StayHealthy, Monrovia, CA, USA)). Thirty-seven patients were studied, mean age 61 +/- 9 years. PPCs developed in 10 patients (27%). Smoking status, lung function, and body composition were similar in both groups. For physical activity, there were significant differences in the time spent sedentary (20.0 +/- 1.5 h/day [PPC], 18.4 +/- 2.1 h/day [non-PPC]; P < 0.05) and in moderate activity (20 +/- 13.7 min/day [PPC], 36 +/- 20.7 min/day [non PPC]; P < 0.01). Patients who developed a PPC engaged in less physical activity than those who did not; hence, targeting physical activity preoperatively may result in less PPCs.