Perioperative rehabilitation and physiotherapy for lung cancer patients with chronic obstructive pulmonary disease.
OBJECTIVE
The purpose of this study was to investigate the impact of pulmonary rehabilitation on surgical morbidity and lung function in lung cancer patients with chronic obstructive pulmonary disease (COPD).


METHODS
Prospectively, 22 lung cancer patients with COPD who underwent lobectomy between 2000 and 2003 were enrolled for this study as a rehabilitation group (Rehab. Group). The criteria of COPD were preoperative forced expiratory volume in 1 second (FEV1)/forced vital capacity (FVC) < or =70% and more than 50% of low attenuation area in a computed tomography. Preoperatively patients performed aggressive pulmonary exercise for two weeks and received chest physiotherapy postoperatively. As a historical control, 60 patients with lung cancer who fulfilled the same criteria but did not receive rehabilitation between 1995 and 1999 (control group) were entered in this study.


RESULTS
Patient backgrounds were all equivalent between the two groups. However, FEV1 and FEV1/FVC were significantly lower in the Rehab. Group (p < 0.05). Prolonged oxygen supplement and tracheostomy tended to be more frequent in the control group. The ratio of actual postoperative to predicted postoperative FEV1 was significantly better in the Rehab. Group (p = 0.047). Furthermore, postoperative hospital stay was significantly longer in the control group (p = 0.0003).


CONCLUSIONS
Despite lower FEV1 and FEV1/FVC in the Rehab. Group, postoperative pulmonary complications and long hospital stay could be effectively prevented and FEV1 was well preserved by rehabilitation and physiotherapy.
Sekine
Yasuo
Y
Department of Thoracic Surgery, Graduate School of Medicine, Chiba University, Japan.
Chiyo
Masako
M
Iwata
Takekazu
T
Yasufuku
Kazuhiro
K
Furukawa
Seiichiro
S
Amada
Yuko
Y
Iyoda
Akira
A
Shibuya
Kiyoshi
K
Iizasa
Toshihiko
T
Fujisawa
Takehiko
T
D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000453:epidemiology* / Q000601:surgery; D015897:Comorbidity; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D007902:Length of Stay; D008175:Lung Neoplasms / Q000453:epidemiology* / Q000601:surgery; D008297:Male; D026741:Physical Therapy Modalities; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology* / Q000503:physiopathology / Q000534:rehabilitation; D014797:Vital Capacity