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) - Gao, Ke
Abstract Background 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. Methods 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. Results 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%) (P = 0.00), as was the rate of postoperative pulmonary complications PPC: group R (12.81%) versus S (13.55%) (P = 0.009); the PPC in the left lung (17.9%) was higher than in the right lung (2.3%) (P = 0.00). The average days in hospital in group S was significantly higher than in group R (P = 0.03). There was no difference between groups in average hospital cost (P = 0.304). Conclusion 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.