Early Recovery After Wedge Resection Surgery to Remove Lung Mestastasis Secondary to Bone Cancer.

Study Overview
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Brief Summary
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After wedge resection surgery, the physiotherapy programs proposed in the literature are heterogeneous and there are few data on the outcomes of such treatments in an oncological population for bone cancer. The aim of the study is to describe the early rehabilitation process after wedge resection surgery secondary to bone tumor pulmonary mestasasis, highlightining the possible functional recovery in the short and medium term after surgery and indentifying the possible prognostic factors.

Detailed Description
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In Italy, the incidence of primary bone tumors is around 0.8-1 case per 100,000 inhabitants, therefore an estimated 500 new cases of primary malignant bone tumors are estimated each year, affecting more frequently in children and young people. The presence of pulmonary metastasis occurs in 30% of the population with bone cancer and is the most common site of metastasis. Where possible, the elective treatment of lung metastases is ablative surgery and the wedge resection technique is also commonly used in the event of repeated metastasis over time. Pulmonary wedge resection surgery does not follow the anatomical limits of the lung but it is customized according to the metastatic area to be removed, thus differentiating itself from lobectomies and other thoracotomy surgical techniques. The trend of vital capacity (CV) and forced expiratory volume in 1s (FEV1), after wedge resection surgery, significantly decrease at 3 months compared to the preoperative evaluation, while at 12 months the CV returns to values close to the preoperative ones and FEV1 remains significantly lower. Rehabilitation treatment is part of the multidisciplinary approach for this type of patient in order to prevent post-surgical respiratory complications (PPC) and shoulder girdle dysfunctions, in the treatment of pain and in the recovery of respiratory volumes. Several authors, describing the physiotherapy treatment techniques, include breathing exercises (Active Cycle Breathing Techniques), early mobilization exercises for the lower limbs and the use of volume incentives. The physiotherapy treatment programs proposed in the literature are heterogeneous and there are no data on the feasibility of such treatments in an oncological population for bone cancer. Patients are enrolled consecutively in a ward of an italian hospital specialized in bone tumor surgery.

Official Title
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Rehabilitation Treatment and Early Recovery After Wedge Resection for Pulmonary Metastasis Secondary to Bone Cancer: an Observational Study.

Conditions
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Metastasis Lung, Bone Neoplasm

Intervention / Treatment
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* Other: assessment of the early recovery after wedge resection surgery


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: over 12 years of age ablative thoracic surgery for metastases localized to the lung and / or chest wall for primary bone cancer must be able to perform the one minute sit-to-stand test in the preoperative physiotherapy evaluation Exclusion Criteria: ablative thoracic surgery for a diagnosis DIFFERENT FROM that of lung metastases

Ages Eligible for Study
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Minimum Age: 12 Years

Sexes Eligible for Study
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All

Study Plan
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How is the study designed?
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Arms and Interventions

| Intervention/Treatment |
| --- |
|Other: assessment of the early recovery after wedge resection surgery|To assess the early recovery will be used 1 minute sit to stand, Numeric Rating scale to assess pain, incentive spirometer to assess vital capacity, Borg modified scale to assess dyspnea.|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| 1 minute sit to stand (Sixth day after surgery) | The test requires the person to stand up from a chair, without the help of the arms, fully extending their knees, and sit down the greatest number of times in the time of one minute. | Sixth day after surgery | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| 1 minute sit to stand (daily) | The test requires the person to stand up from a chair, without the help of the arms, fully extending their knees, and sit down the greatest number of times in the time of one minute. | every day after surgery up to 7 day; at 3, 6 and 12 months after surgery. | 
| pain intensity | numeric rating scale (from 0 (no pain) to 10 (worst possible pain)) | every day after surgery up to 7 day, twice a day | 
| vital capacity (ml) | the vital capacity will be assess with incentive spirometer named respirex | every day after surgery up to 7 day, twice a day | 
| heart rate (bpm) | beats per minute; it will be assess with pulse oximeter | once a day, before and after 1 minute sit to stand test, up to 7 day | 
| peripheral oxygen saturation (SpO2 %) | it will be assess with pulse oximeter | once a day, before and after 1 minute sit to stand test, up to 7 day | 
| mBorg Score | dyspnea (shortness of breath, sometimes described as air hunger) it will be assess using Borg Modified Scale, from 0 to 10, when 0 means none (better outcome) and 10 means maximum (worse outcome). | once a day, before and after 1 minute sit to stand test, up to 7 day | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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pulmonary rehabilitation, wedge resection, early recovery