Sjaak Pouwels1, Besir Topal2, Joost F Ter Woorst3, Marc P Buise4, Ghada M Shahin5, Martijn A Spruit6,7,8,9, Frank W J M Smeenk10,11. 1. Department of Surgery, HMC Westeinde, Lijnbaan 32, P.O. Box 432, 2501 CK, The Hague, The Netherlands. Sjaakpwls@gmail.com. 2. Department of Cardiothoracic Surgery, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands. 3. Department of Cardiothoracic Surgery, Catharina Hospital, Eindhoven, The Netherlands. 4. Department of Anaesthesiology, Intensive Care and Pain Medicine, Catharina Hospital, Eindhoven, The Netherlands. 5. Department of Cardiothoracic Surgery, Isala Hospital, Zwolle, The Netherlands. 6. Department of Research and Education, CIRO+, Horn, The Netherlands. 7. Department of Respiratory Medicine, Maastricht University Medical Centre (MUMC+), Maastricht, The Netherlands. 8. NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht, The Netherlands. 9. REVAL - Rehabilitation Research Center, BIOMED - Biomedical Research Institute, Faculty of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium. 10. Department of Respiratory Medicine, Catharina Hospital, Eindhoven, The Netherlands. 11. SHE School of Health Professions Education, Maastricht University, Maastricht, The Netherlands.
Abstract
BACKGROUND: Preoperative exercise training (PET) studies show promising results in various patient populations. However, the lack of standardised programmes and uniformity in practice guidelines are barriers for implementation. Aim of this study was to assess the current opinions of pulmonologists and cardiothoracic surgeons on the clinical applicability of PET in patients scheduled for lung cancer surgery. METHODS: Dutch pulmonologists and cardiothoracic surgeons were asked to complete a 29-question survey regarding PET as an additional option to further optimise the health status of patients scheduled for lung cancer surgery. RESULTS: In total, 47 respondents (63% response rate), including 30 pulmonologists and 11 cardiothoracic surgeons and 6 residents in training completed the survey. A vast majority of the respondents had a positive attitude towards PET. Home-based exercise was considered less useful, as well as unsupervised exercise. Patient's motivation, improvements in physical capacity and quality of life, and lifestyle adjustments are important factors for the success of PET. The programme should at least contain inspiratory muscle training (95.7%), lifestyle interventions (95.7%), and supervised exercise training (91.5%). Cardiac and pulmonary risk assessment and medication assessment and optimisation were found less important. CONCLUSION: Among pulmonologists and cardiothoracic surgeons, there is a tendency that PET can be a valuable addition to the perioperative care of lung surgery patients. Points of discussion are the contents of PET programmes, and there seems to be a lack of awareness among chest physicians.
BACKGROUND: Preoperative exercise training (PET) studies show promising results in various patient populations. However, the lack of standardised programmes and uniformity in practice guidelines are barriers for implementation. Aim of this study was to assess the current opinions of pulmonologists and cardiothoracic surgeons on the clinical applicability of PET in patients scheduled for lung cancer surgery. METHODS: Dutch pulmonologists and cardiothoracic surgeons were asked to complete a 29-question survey regarding PET as an additional option to further optimise the health status of patients scheduled for lung cancer surgery. RESULTS: In total, 47 respondents (63% response rate), including 30 pulmonologists and 11 cardiothoracic surgeons and 6 residents in training completed the survey. A vast majority of the respondents had a positive attitude towards PET. Home-based exercise was considered less useful, as well as unsupervised exercise. Patient's motivation, improvements in physical capacity and quality of life, and lifestyle adjustments are important factors for the success of PET. The programme should at least contain inspiratory muscle training (95.7%), lifestyle interventions (95.7%), and supervised exercise training (91.5%). Cardiac and pulmonary risk assessment and medication assessment and optimisation were found less important. CONCLUSION: Among pulmonologists and cardiothoracic surgeons, there is a tendency that PET can be a valuable addition to the perioperative care of lung surgery patients. Points of discussion are the contents of PET programmes, and there seems to be a lack of awareness among chest physicians.
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