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 .
Long-term impact of developing a postoperative pulmonary complication after lung surgery
Introduction Postoperative pulmonary complications ( PPC ) such as atelectasis and pneumonia are common following lung resection . PPCs have a significant clinical impact on postoperative morbidity and mortality . We studied the long-term effects of PPCs and sought to identify independent risk factors . Methods A prospect i ve observational study involved all patients following lung resection in a regional thoracic centre over 4 years .  PPCs were assessed daily in hospital using the Melbourne group scale based on chest X-ray , white cell count , fever , purulent sputum , microbiology , oxygen saturations , physician diagnosis and intensive therapy unit (ITU)/high-dependency unit readmission . Follow-up included hospital length of stay ( LOS ) , 30-day readmissions , and mortality . Results 86 of 670 patients ( 13 % ) who had undergone a lung resection developed a PPC . Those patients had a significantly longer hospital LOS in days ( 13 , 95 % CI 10.5–14.9 vs 6.3 , 95 % CI 5.9 to 6.7 ; p<0.001 ) and higher rates of ITU admissions ( 28 % vs 1.9 % ; p<0.001 ) and 30-day hospital readmissions ( 20.7 % vs 11.9 % ; p<0.05 ) . Significant independent risk factors for development of PPCs were COPD and smoking ( p<0.05 ) , not age . Excluding early postoperative deaths , developing a PPC result ed in a significantly reduced overall survival in months ( 40 , 95 % CI 34 to 44 vs 46 , 95 % CI 44 to 47 ; p=0.006 ) . Those who developed a PPC had a higher rate of non-cancer-related deaths ( 11 % vs 5 % ; p=0.020 ) . PPC is a significant independent risk factor for late deaths in non-small cell lung cancer patients ( HR 2.0 , 95 % CI 1.9 to 3.2 ; p=0.006 ) . Conclusions Developing a PPC after thoracic surgery is common and is associated with a poorer long-term outcome
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 .