In conclusion , preoperative exercise-based training improves pulmonary function before surgery and reduces in-hospital length of stay and postoperative complications after lung resection surgery for lung cancer
Lung cancer is the leading cause of cancer-related death worldwide .
For early stages of the disease , lung resection surgery remains the best treatment with curative intent , but significant morbidity is associated , especially among patients with poor pulmonary function and cardiorespiratory fitness .
In those cases , the implementation of a preoperative exercise-based intervention could optimize patient 's functional status before surgery and improve postoperative outcomes and enhance recovery .
The aim of this systematic review is to provide the current body of knowledge regarding the effectiveness of a preoperative exercise-based intervention on postoperative and functional outcomes in patients with lung cancer su bmi tted to lung resection surgery .
Preoperative pulmonary rehabilitation before lung cancer resection: results from two randomized studies.
Complete surgical resection is the most effective curative treatment for lung cancer . However , many patients with lung cancer also have severe COPD which increases their risk of postoperative complications and their likelihood of being considered " inoperable . " Preoperative pulmonary rehabilitation ( PR ) has been proposed as an intervention to decrease surgical morbidity but there is no established protocol and no r and omized study has been published to date . We tested two preoperative PR interventions in patients undergoing lung cancer resection and with moderate-severe COPD in a r and omized single blinded design . Outcomes were length of hospital stay and postoperative complications . The first study tested 4 weeks of guideline -based PR vs. usual care : that study proved to be very difficult to recruit as patients and providers were reluctant to delay surgery . Nine patients were r and omized and no differences were found between arms . The second study tested ten preoperative PR sessions using a customized protocol with nonst and ard components ( exercise prescription based on self efficacy , inspiratory muscle training , and the practice of slow breathing ) ( n=10 ) vs. usual care ( n=9 ) . The PR arm had shorter length of hospital stay by 3 days ( p=0.058 ) , fewer prolonged chest tubes ( 11 % vs. 63 % , p=0.03 ) and fewer days needing a chest tube ( 8.8 vs. 4.3 days p=0.04 ) compared to the controlled arm . A ten-session preoperative PR intervention may improve post operative lung reexpansion evidence d by shorter chest tube times and decrease the length of hospital stay , a crude estimator of post operative morbidity and costs . Our results suggest the potential for short term preoperative pulmonary rehabilitation interventions in patients with moderate-severe COPD undergoing curative lung resection . 4 weeks of conventional preoperative PR seems non feasible
In conclusion , preoperative exercise-based training improves pulmonary function before surgery and reduces in-hospital length of stay and postoperative complications after lung resection surgery for lung cancer
Lung cancer is the leading cause of cancer-related death worldwide .
For early stages of the disease , lung resection surgery remains the best treatment with curative intent , but significant morbidity is associated , especially among patients with poor pulmonary function and cardiorespiratory fitness .
In those cases , the implementation of a preoperative exercise-based intervention could optimize patient 's functional status before surgery and improve postoperative outcomes and enhance recovery .
The aim of this systematic review is to provide the current body of knowledge regarding the effectiveness of a preoperative exercise-based intervention on postoperative and functional outcomes in patients with lung cancer su bmi tted to lung resection surgery .