A study for 342 cases
Gao, Ke; Yu, Peng‐ming; Su, Jian‐hua; He, Cheng‐qi; Liu, Lun‐xu; Zhou,
Yu‐bin; Pu, Qiang; Che, Guo‐wei.

Thoracic Cancer, July 2015, Vol. 6  Issue: Number 4 p443-449, 7p;

Abstract: 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. 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. 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%)
versusS(13.55%) (P= 0.009); the PPCin 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).
Pre‐operative screening using CPETis conducive to identifying high‐risk
patients for lung resection. Pre‐operative pulmonary rehabilitation is
helpful to reduce postoperative complications and improve fast‐track
recovery.