Evidence map›Paper›PMID 40178716›Full record

Trial reportEsophagus : official journal of the Japan Esophageal Society2025

Preoperative inspiratory muscle training preserved diaphragmatic excursion after esophagectomy: a randomized-controlled trial.

Hiroki Mizusawa, Yuji Higashimoto, Osamu Shiraishi, Masashi Shiraishi, Ryuji Sugiya, Masaya Noguchi, Kengo Kanki, Tamotsu Kimura, Akira Ishikawa, Takushi Yasuda

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in Esophagus : official journal of the Japan Esophageal Society, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Hiroki MizusawaFaculty of Medicine, Department of Rehabilitation Medicine, Kindai University, 377-2, Ohno-higashi, Osakasayama, 589-5811, Japan. hiroki-mizusawa@med.kindai.ac.jp.ORCID 0000-0001-8324-4294
Yuji HigashimotoFaculty of Medicine, Department of Rehabilitation Medicine, Kindai University, 377-2, Ohno-higashi, Osakasayama, 589-5811, Japan.
Osamu ShiraishiFaculty of Medicine, Department of Surgery, Kindai University, Osaka, Japan.
Masashi ShiraishiFaculty of Medicine, Department of Rehabilitation Medicine, Kindai University, 377-2, Ohno-higashi, Osakasayama, 589-5811, Japan.
Ryuji SugiyaFaculty of Medicine, Department of Rehabilitation Medicine, Kindai University, 377-2, Ohno-higashi, Osakasayama, 589-5811, Japan.
Masaya NoguchiFaculty of Medicine, Department of Rehabilitation Medicine, Kindai University, 377-2, Ohno-higashi, Osakasayama, 589-5811, Japan.
Kengo KankiFaculty of Medicine, Department of Rehabilitation Medicine, Kindai University, 377-2, Ohno-higashi, Osakasayama, 589-5811, Japan.
Tamotsu KimuraFaculty of Medicine, Department of Rehabilitation Medicine, Kindai University, 377-2, Ohno-higashi, Osakasayama, 589-5811, Japan.
Akira IshikawaDepartment of Public Health, Graduate School of Health Sciences, Kobe University, Kobe, Japan.
Takushi YasudaFaculty of Medicine, Department of Surgery, Kindai University, Osaka, Japan.

Funding

Japan Society for the Promotion of Science 24K20485
6 · The paper itself

Abstract

backgroundPreoperative inspiratory muscle training (IMT) enhances diaphragmatic excursion (DE) in patients with esophageal cancer; however, the postoperative effects of IMT on DE have not yet been evaluated. This study aimed to investigate the effect of preoperative IMT on perioperative diaphragmatic function as measured by DE, inspiratory muscle strength, lung function, and exercise tolerance.

methodsThis was a parallel, randomized-controlled trial. Patients with thoracic or abdominal esophageal cancer scheduled for esophagectomy were randomized into either the incentive spirometry (IS) or IMT group. Each intervention was performed during preoperative neoadjuvant chemotherapy (NAC). The primary outcome was the DE, and the secondary outcomes were maximal inspiratory pressure (MIP), lung function, and exercise tolerance, which were measured before and 1-3 months after esophagectomy.

resultsThirty-two patients were included in the analysis. The DE in the IMT group (n = 15) increased from baseline to pre-operation, and the rate of change was significantly greater than that in the IS group (n = 17). Although the DE and MIP decreased in both groups after esophagectomy, the decline in the DE after esophagectomy was significantly lower in the IMT group than that in the IS group (p < 0.05). Furthermore, significant differences in DE persisted at least until 3 months post-esophagectomy, whereas MIP did not differ significantly at any time point. Pulmonary function and exercise tolerance were not significantly different between the two groups.

conclusionsThe IMT before esophagectomy enhanced diaphragmatic function, which was preserved for more than 3 months after esophagectomy.

Indexed as

Breathing ExercisesDiaphragmEsophageal NeoplasmsEsophagectomyPreoperative CareRespiratory MusclesAgedExercise ToleranceFemaleHumansMaleMiddle AgedMuscle StrengthNeoadjuvant TherapyRespiratory Function TestsSpirometryDiaphragmEsophagectomyMaximal inspiratory pressureRespiratory muscle trainingUltrasonography

Identifiers

PMID40178716
PMCPMC12167333

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.