Preoperative exercise training may reduce the risk of developing a postoperative pulmonary complication , the duration of intercostal catheter use , postoperative length of hospital stay , and improve both exercise capacity and FVC in people undergoing lung resection for NSCLC .
BACKGROUND Surgical resection for early stage non-small cell lung cancer ( NSCLC ) offers the best chance of cure , but is associated with a risk of postoperative pulmonary complications ( i.e. pneumonia ( new infiltrate coupled with either fever ( > 38º C ) and purulent secretions , or fever and white cell count > 11,000 ) , bronchopleural fistula , severe atelectasis that requires chest physiotherapy or bronchoscopy , and prolonged mechanical ventilation ( > 48 hours ) ) .
It is currently unclear if preoperative exercise training , and the potential result ant improvement in exercise capacity , may also improve postoperative outcomes , such as the risk of developing postoperative pulmonary complications , the length of postoperative intercostal drainage , or the length of hospital stay .
OBJECTIVES The primary aims of this study were to determine the effect of preoperative exercise training on postoperative outcomes , such as risk of developing a postoperative pulmonary complication , and postoperative duration of intercostal catheter use in adults scheduled to undergo lung resection for NSCLC .
The secondary aims of this study were to determine the effect of preoperative exercise training  on length of hospital stay , fatigue , dyspnoea , exercise capacity , lung function , and postoperative mortality .
Postoperative pulmonary complications following thoracic surgery: are there any modifiable risk factors?
Background Postoperative pulmonary complications ( PPC ) are the most frequently observed complications following lung resection , of which pneumonia and atelectasis are the most common . PPCs have a significant clinical and economic impact associated with increased observed number of deaths , morbidity , length of stay and associated cost . The aim of this study was to assess the incidence and impact of PPCs and to identify potentially modifiable independent risk factors . Methods A prospect i ve observational study was carried out on all patients following lung resection via thoracotomy in a regional thoracic centre over 13 months .  PPC was assessed using a scoring system based on chest x-ray , raised white cell count , fever , microbiology , purulent sputum and oxygen saturations . Results Thirty-four of 234 subjects ( 14.5 % ) had clinical evidence of PPC . The PPC patient group had a significantly longer length of stay ( LOS ) in hospital , high dependency unit ( HDU ) LOS , higher frequency of intensive care unit ( ITU ) admission and a higher number of hospital deaths . Older patients , body mass index ( BMI ) ≥30 kg/m2 , preoperative activity < 400 m , American Society of Anesthesiologists ( ASA ) score ≥3 , smoking history , chronic obstructive pulmonary disease ( COPD ) , lower preoperative forced expiratory volume in 1 s ( FEV1 ) and predicted postoperative ( PPO ) FEV1 were all significantly ( p<0.05 ) associated with PPC on univariate analysis . Multivariate analysis confirmed that age > 75 years , BMI ≥30 kg/m2 , ASA ≥3 , smoking history and COPD were significant independent risk factors in the development of PPC ( p<0.05 ) . Conclusion The clinical impact of PPCs is marked . Significant independent preoperative risk factors have been identified in current clinical practice . Potentially modifiable risk factors include BMI , smoking status and COPD . The impact of targeted therapy requires further evaluation
Preoperative exercise training may reduce the risk of developing a postoperative pulmonary complication , the duration of intercostal catheter use , postoperative length of hospital stay , and improve both exercise capacity and FVC in people undergoing lung resection for NSCLC .
BACKGROUND Surgical resection for early stage non-small cell lung cancer ( NSCLC ) offers the best chance of cure , but is associated with a risk of postoperative pulmonary complications ( i.e. pneumonia ( new infiltrate coupled with either fever ( > 38º C ) and purulent secretions , or fever and white cell count > 11,000 ) , bronchopleural fistula , severe atelectasis that requires chest physiotherapy or bronchoscopy , and prolonged mechanical ventilation ( > 48 hours ) ) .
It is currently unclear if preoperative exercise training , and the potential result ant improvement in exercise capacity , may also improve postoperative outcomes , such as the risk of developing postoperative pulmonary complications , the length of postoperative intercostal drainage , or the length of hospital stay .
OBJECTIVES The primary aims of this study were to determine the effect of preoperative exercise training on postoperative outcomes , such as risk of developing a postoperative pulmonary complication , and postoperative duration of intercostal catheter use in adults scheduled to undergo lung resection for NSCLC .
The secondary aims of this study were to determine the effect of preoperative exercise training  on length of hospital stay , fatigue , dyspnoea , exercise capacity , lung function , and postoperative mortality .