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 .
Peak oxygen consumption during cardiopulmonary exercise test improves risk stratification in candidates to major lung resection.
BACKGROUND The objective of this investigation was to assess the association of peak oxygen consumption ( Vo(2 ) ) with postoperative outcome in a prospect i ve cohort of patients undergoing major lung resection for the treatment of lung cancer . METHODS Preoperative symptom-limited cardiopulmonary exercise testing ( CPET ) performed using cycle ergometry was conducted in 204 consecutive patients who had undergone pulmonary lobectomy or pneumonectomy .  Peak Vo(2 ) was tested for possible association with postoperative cardiopulmonary complications and mortality . Logistic regression analysis , vali date d by a bootstrap analysis , was used to adjust for the effect of other perioperative factors . The role of peak Vo(2 ) in stratifying the surgical risk was further assessed in different groups of patients subdivided according to their cardiorespiratory status . RESULTS Logistic regression showed that peak Vo(2 ) was an independent and reliable predictor of pulmonary complications ( p = 0.04 ) . All six deaths occurred in patients with a peak Vo(2 ) of < 20 mL/kg/min ( four deaths in patients with a peak Vo(2 ) of < 12 mL/kg/min ) . The mortality rate in this high-risk group was 10-fold higher ( 4 of 30 patients ; 13 % ) compared to those with higher peak Vo(2 ) ( p = 0.006 ) . Compared to patients with a peak Vo(2 ) of > 20 mL/kg/min , those with a peak Vo(2 ) of < 12 mL/kg/min had 5-fold , 8-fold , 5-fold , and 13-fold higher rates , respectively , of total cardiopulmonary complications pulmonary complications , cardiac complications , and mortality . CONCLUSIONS The present study supports a more liberal use of CPET before lung resection compared to the current guidelines since this test can help in stratifying the surgical risk and optimizing perioperative care
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 .