Preoperative shuttle walking testing and outcome after oesophagogastrectomy

Area of Science:

• Cardiology
• Thoracic Surgery
• Exercise Physiology

Background:

• Objective assessment of cardiorespiratory reserve is crucial for identifying high-risk surgical patients.
• Formal cardiopulmonary exercise (CPX) testing is often inaccessible in smaller medical centers.
• Previous audits highlighted the need for improved preoperative risk assessment in esophagectomy.

Purpose of the Study:

• To evaluate the utility of a simpler exercise test for preoperative risk stratification.
• To assess the correlation between shuttle walk test distance and 30-day outcomes after esophagectomy.

Main Methods:

• Fifty-one patients undergoing esophagectomy for cancer completed an incremental shuttle walk test preoperatively.
• Thirty-day postoperative morbidity and mortality data were collected and analyzed.

Main Results:

• Overall 30-day mortality was 10%.
• No patient achieving 350 meters or more on the shuttle walk test died within 30 days.
• Five of eight patients unable to reach 350 meters died; two others required extended critical care.

Conclusions:

• Preoperative shuttle walk testing is a sensitive indicator of operative risk in esophagectomy patients.
• A threshold of 350 meters on the shuttle walk test appears to predict favorable outcomes.
• This simpler test aligns with findings from formal cardiopulmonary exercise testing for functional capacity assessment.