Yutian Lai1, Jian Huang2, Mei Yang1, Jianhua Su3, Jing Liu4, Guowei Che5. 1. Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, P.R. China. 2. Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, P.R. China. Electronic address: scuhuangjian@yahoo.com. 3. Rehabilitation Department, West China Hospital, Sichuan University, Chengdu, P.R. China. 4. Department of Postgraduates, West China School of Public Health, Sichuan University, Chengdu, P.R. China. 5. Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, P.R. China. Electronic address: guowei_che@yahoo.com.
Abstract
BACKGROUND: As a newly developed treatment, preoperative pulmonary rehabilitation (PR) has been studied in depth. However, few studies have assessed the relationship between advanced age and a shorter term intensive pattern of preoperative PR in patients with lung cancer (LC) and especially those patients waiting for therapeutic LC surgeries. This study investigated short-term preoperative PR combined with inspiratory muscle training (IMT) and aerobic endurance training in elderly patients scheduled to undergo LC lobectomy. METHODS: A prospective randomized controlled trial with a total of 60 subjects aged ≥70 y was conducted. The intervention group (PR group) was treated for 1 wk with systematic and highly intensive preoperative PR training before lobectomy, and the control group (NPR group) was treated with conventional preoperative respiratory management. We analyzed the 6-min walking distance (6-MWD), the peak expiratory flow (PEF), and quality-of-life scores before and after the rehabilitation regimen as well as the incidence of postoperative pulmonary complications (PPCs). RESULTS: In total, 30 patients (PR group) completely executed the 7-d intensive preoperative PR, and 30 patients (NPR group) served as the control group. The two groups were comparable at baseline. During the preoperative PR, a significantly longer 6-MWD (increase: 28.6 ± 18.2 versus 9.4 ± 27.0 m; between-groups difference: 19.2 m, P = 0.029) and an increased PEF (increase: 26.2 ± 22.5 versus 8.2 ± 10.3 L/min; between-groups difference: 18.0 L/min, P < 0.001) were noted in the PR group compared with the NPR group. After LC surgery, the mean postoperative length of stay (6.9 ± 4.4 versus 10.7 ± 6.4 d, P = 0.010) and total hospital stay (16.0 ± 4.5 versus 19.7 ± 6.5 d, P = 0.012) were significantly reduced in the PR group. Thirty-day PPCs were noted in four (13.3%) patients in the PR group and 11 (36.7%) patients in the NPR group, with a significant difference between the two groups (P = 0.037). CONCLUSIONS: For elderly LC patients scheduled to undergo surgery in China, a 7-d intensive pattern of preoperative PR combined with IMT and aerobic endurance training may be a feasible rehabilitation strategy with positive physical and psychological effects.
RCT Entities:
BACKGROUND: As a newly developed treatment, preoperative pulmonary rehabilitation (PR) has been studied in depth. However, few studies have assessed the relationship between advanced age and a shorter term intensive pattern of preoperative PR in patients with lung cancer (LC) and especially those patients waiting for therapeutic LC surgeries. This study investigated short-term preoperative PR combined with inspiratory muscle training (IMT) and aerobic endurance training in elderly patients scheduled to undergo LC lobectomy. METHODS: A prospective randomized controlled trial with a total of 60 subjects aged ≥70 y was conducted. The intervention group (PR group) was treated for 1 wk with systematic and highly intensive preoperative PR training before lobectomy, and the control group (NPR group) was treated with conventional preoperative respiratory management. We analyzed the 6-min walking distance (6-MWD), the peak expiratory flow (PEF), and quality-of-life scores before and after the rehabilitation regimen as well as the incidence of postoperative pulmonary complications (PPCs). RESULTS: In total, 30 patients (PR group) completely executed the 7-d intensive preoperative PR, and 30 patients (NPR group) served as the control group. The two groups were comparable at baseline. During the preoperative PR, a significantly longer 6-MWD (increase: 28.6 ± 18.2 versus 9.4 ± 27.0 m; between-groups difference: 19.2 m, P = 0.029) and an increased PEF (increase: 26.2 ± 22.5 versus 8.2 ± 10.3 L/min; between-groups difference: 18.0 L/min, P < 0.001) were noted in the PR group compared with the NPR group. After LC surgery, the mean postoperative length of stay (6.9 ± 4.4 versus 10.7 ± 6.4 d, P = 0.010) and total hospital stay (16.0 ± 4.5 versus 19.7 ± 6.5 d, P = 0.012) were significantly reduced in the PR group. Thirty-day PPCs were noted in four (13.3%) patients in the PR group and 11 (36.7%) patients in the NPR group, with a significant difference between the two groups (P = 0.037). CONCLUSIONS: For elderly LC patients scheduled to undergo surgery in China, a 7-d intensive pattern of preoperative PR combined with IMT and aerobic endurance training may be a feasible rehabilitation strategy with positive physical and psychological effects.
Authors: Sean M Stokes; Elliot Wakeam; Mara B Antonoff; Leah M Backhus; Robert A Meguid; David Odell; Thomas K Varghese Journal: J Thorac Dis Date: 2019-03 Impact factor: 2.895
Authors: Caroline Himbert; Nicole Klossner; Adriana M Coletta; Christopher A Barnes; Joachim Wiskemann; Paul C LaStayo; Thomas K Varghese; Cornelia M Ulrich Journal: Crit Rev Oncol Hematol Date: 2020-09-13 Impact factor: 6.312
Authors: Alberto Codima; Willian das Neves Silva; Ana Paula de Souza Borges; Gilberto de Castro Journal: Support Care Cancer Date: 2020-05-09 Impact factor: 3.603