# Positive effects of a perioperative training intervention in Ivor Lewis oesophageal surgery: a randomised, controlled multicentre trial

## TL;DR

A study found that respiratory muscle training before and after oesophageal cancer surgery improved lung function and reduced complications, but other types of training did not.

## Contribution

This study is the first to show that respiratory muscle training in oesophageal surgery patients improves postoperative respiratory outcomes.

## Key findings

- The intervention group showed improved maximal inspiratory and expiratory pressures and peak expiratory flow.
- The intervention group had fewer pulmonary complications compared to the control group.
- Strength training and increased physical activity did not show significant benefits.

## Abstract

The effects of peri-operative training interventions in connection with oesophageal surgery have not been thoroughly investigated. The aim of this randomised, controlled, single-blind study was to evaluate a peri-operative physical training programme in patients undergoing oesophageal cancer resection surgery due to cancer of the oesophagus or the gastro-oesophageal junction.

One hundred patients scheduled to undergo Ivor Lewis oesophagectomy in one of five university hospitals in Sweden were randomised to a control group or intervention including respiratory muscle training, strength training, and increased physical activity before surgery and up to 3 months postoperatively. Outcome measures were physical capacity, respiratory muscle strength, spirometry, grip strength, and chest mobility. Questionnaires regarding physical activity and function, recovery, and health-related quality of life were completed at inclusion and 3 and 12 months postoperatively.

We did not find significant differences between the groups in physical capacity during follow-up. However, the intervention group performed significantly better than the control group in maximal inspiratory pressure (Δ18%), maximal expiratory pressure (Δ18%), and peak expiratory flow (Δ12%) 3 months postoperatively (p < 0.05). Patients in the intervention group also developed fewer pulmonary complications (p = 0.019). We did not find differences between the groups in recovery or health-related quality of life.

A peri-operative training intervention including respiratory muscle training had a positive impact on respiratory function and pulmonary complications. However, neither strength training nor increased physical activity had any effects. Thus, respiratory muscle training may be offered as a peri-operative regimen in oesophageal cancer surgery.

FoU i VGR 238,651 (Released Dec 15, 2017), Clinical Trials NCT03452319 (Released Feb 18, 2018).

The online version contains supplementary material available at 10.1186/s12893-025-03416-4.