Cardiopulmonary exercise testing screening and pre‐operative pulmonary rehabilitation reduce postoperative complications and improve fast‐track recovery after lung cancer surgery: A study for 342 cases. Issue 4 (22nd December 2014)

• Record Type: Journal Article
• Authors: Gao, Ke; Yu, Peng‐ming; Su, Jian‐hua; He, Cheng‐qi; Liu, Lun‐xu; Zhou, Yu‐bin; Pu, Qiang; Che, Guo‐wei
• Is Part Of: Thoracic cancer. Volume 6:Issue 4(2015)
• Page Start: 443
• Page End: 449
• Publication Date: 2014-12-22
• Subjects: Chest -- Cancer -- Periodicals; Chest -- Cancer -- Treatment -- Periodicals; Chest -- Surgery -- Periodicals; 616.99494005
• DOI: 10.1111/1759-7714.12199
• Languages: English
• ISSNs: 1759-7706

Abstract

<abstract abstract-type="main"> <title>Abstract</title> <sec id="tca12199-sec-0001" sec-type="section"> <title>Background</title> <p>An evaluation of cardiopulmonary exercise testing (CPET) screening and pre‐operative pulmonary rehabilitation in reducing postoperative complications and improving fast‐track recovery in high‐risk patients who undergo resection for lung cancer.</p> </sec> <sec id="tca12199-sec-0002" sec-type="section"> <title>Methods</title> <p>Of 342 potential lung cancer cases, 142 high‐risk patients were finally divided into two groups: group R (n = 71) underwent an intensive pre‐operative pulmonary rehabilitation program (PRP), followed by lobectomy; group S (n = 71) underwent only lobectomy with conventional management. Postoperative complications, average days in hospital, postoperative days in hospital, and cost were analyzed.</p> </sec> <sec id="tca12199-sec-0003" sec-type="section"> <title>Results</title> <p>The 142 high‐risk patients were screened by smoking history and CPET. Sixty‐eight patients had bronchial hyperresponsiveness (BHR) and 47 patients had peak expiratory flow <250 L/minute by CPET. The rate of postoperative total complications in group R (16.90%) was significantly lower than in group S (83.31%) (<italic>P</italic> = 0.00), as was the rate of postoperative pulmonary complications PPC: group R (12.81%) <italic>versus</italic> S (13.55%) (<italic>P</italic> = 0.009); the PPC in the left lung (17.9%) was higher than in the right lung (2.3%) (<italic>P</italic> = 0.00). The average days in hospital in group S was significantly higher than in group R (<italic>P</italic> = 0.03). There was no difference between groups in average hospital cost (<italic>P</italic> = 0.304).</p> </sec> <sec id="tca12199-sec-0004" sec-type="section"> <title>Conclusion</title> <p>Pre‐operative screening using CPET is conducive to identifying high‐risk patients for lung resection. Pre‐operative pulmonary rehabilitation is helpful to reduce postoperative complications and improve fast‐track recovery.</p> </sec> </abstract>