High-intensity interval training ( HIT ) with duration of 2 to 6 weeks seems to be the best exercise programme in a prehabilitation intervention but it exists heterogeneity in terms of intensity and duration .
Prehabilitation increase exercise capacity and significantly enhances pulmonary function .
But the reduction of postoperative complication and mortality has not been clearly demonstrated .
It seems that not all patients can benefit from prehabilitation and it could be indicated only in patients with impaired lung function .
Meanwhile , safety of prehabilitation and good results of some studies support this intervention in high-risk patients
Surgical resection remains the best treatment option for patients with early stage of non-small cell lung cancer ( NSCLC ) .
However , it may be responsible of postoperative complication and mortality , especially in patients with impaired pulmonary function .
Enhanced recovery after surgery ( ERAS ) programs have been focused mainly in minimal invasive surgery approach during lung resection and respiratory rehabilitation after surgery .
Preoperative exercise-based intervention ( prehabilitation ) has demonstrated reduction of morbi-mortality in other surgeries but in thoracic surgery continues to be under discussion .
Cardio-pulmonary exercise test ( CPET ) is the gold st and ard technique to predict postoperative morbi-mortality .
The implementation of a preoperative respiratory rehabilitation could optimize patient 's physical capacity before surgery and improve outcomes and enhance recovery .
The aim of this systematic review of the literature is to identify the effectiveness and safety of prehabilitation programs in thoracic surgery , the type of exercise and its duration , and the group of patients with best benefit .
Prehabilitation is a safe intervention without side effects in patients .
A randomized trial comparing lung-volume-reduction surgery with medical therapy for severe emphysema.
BACKGROUND Lung-volume-reduction surgery has been proposed as a palliative treatment for severe emphysema . Effects on mortality , the magnitude and durability of benefits , and criteria for the selection of patients have not been established . METHODS A total of 1218 patients with severe emphysema underwent pulmonary rehabilitation  and were r and omly assigned to undergo lung-volume-reduction surgery or to receive continued medical treatment . RESULTS Overall mortality was 0.11 death per person-year in both treatment groups ( risk ratio for death in the surgery group , 1.01 ; P=0.90 ) . After 24 months , exercise capacity had improved by more than 10 W in 15 percent of the patients in the surgery group , as compared with 3 percent of patients in the medical-therapy group ( P<0.001 ) . With the exclusion of a subgroup of 140 patients at high risk for death from surgery according to an interim analysis , overall mortality in the surgery group was 0.09 death per person-year , as compared with 0.10 death per person-year in the medical-therapy group ( risk ratio , 0.89 ; P=0.31 ) ; exercise capacity after 24 months had improved by more than 10 W in 16 percent of patients in the surgery group , as compared with 3 percent of patients in the medical-therapy group ( P<0.001 ) . Among patients with predominantly upper-lobe emphysema and low exercise capacity , mortality was lower in the surgery group than in the medical-therapy group ( risk ratio for death , 0.47 ; P=0.005 ) . Among patients with non-upper-lobe emphysema and high exercise capacity , mortality was higher in the surgery group than in the medical-therapy group ( risk ratio , 2.06 ; P=0.02 ) . CONCLUSIONS Overall , lung-volume-reduction surgery increases the chance of improved exercise capacity but does not confer a survival advantage over medical therapy . It does yield a survival advantage for patients with both predominantly upper-lobe emphysema and low base-line exercise capacity . Patients previously reported to be at high risk and those with non-upper-lobe emphysema and high base-line exercise capacity are poor c and i date s for lung-volume-reduction surgery , because of increased mortality and negligible functional gain
High-intensity interval training ( HIT ) with duration of 2 to 6 weeks seems to be the best exercise programme in a prehabilitation intervention but it exists heterogeneity in terms of intensity and duration .
Prehabilitation increase exercise capacity and significantly enhances pulmonary function .
But the reduction of postoperative complication and mortality has not been clearly demonstrated .
It seems that not all patients can benefit from prehabilitation and it could be indicated only in patients with impaired lung function .
Meanwhile , safety of prehabilitation and good results of some studies support this intervention in high-risk patients
Surgical resection remains the best treatment option for patients with early stage of non-small cell lung cancer ( NSCLC ) .
However , it may be responsible of postoperative complication and mortality , especially in patients with impaired pulmonary function .
Enhanced recovery after surgery ( ERAS ) programs have been focused mainly in minimal invasive surgery approach during lung resection and respiratory rehabilitation after surgery .
Preoperative exercise-based intervention ( prehabilitation ) has demonstrated reduction of morbi-mortality in other surgeries but in thoracic surgery continues to be under discussion .
Cardio-pulmonary exercise test ( CPET ) is the gold st and ard technique to predict postoperative morbi-mortality .
The implementation of a preoperative respiratory rehabilitation could optimize patient 's physical capacity before surgery and improve outcomes and enhance recovery .
The aim of this systematic review of the literature is to identify the effectiveness and safety of prehabilitation programs in thoracic surgery , the type of exercise and its duration , and the group of patients with best benefit .
Prehabilitation is a safe intervention without side effects in patients .