Post-operative respiratory rehabilitation after lung resection for non-small cell lung cancer.
BACKGROUND
To investigate the efficacy of an inpatient Pulmonary Rehabilitation program (i-PR) after lung resection (LR) for Non-Small Cell Lung Cancer (NSCLC).


METHODS
From January 2001 to December 2004, 211 out of 618 patients who underwent LR were considered eligible for i-PR. Twenty-five patients accepted the i-PR and were included in the case group. The remaining 186 who refused i-PR were taken as controls.


RESULTS
The two study groups were comparable for demographic and surgical characteristics, as well as for the peri-operative morbidity (4% in the controls and 3% among patients undergoing i-PR). Most functional parameters among treated patients were improved when baseline versus 1-month figures were compared, despite the strong correction for multiple comparison limited statistical significance to Borg scale dyspnoea on exertion - median - (2 versus 0; p<0.01); pH (7.45 versus 7.42; p<0.05); timed walk-6MWD (297.8m versus 393.4m; p<0.01) and Hb saturation during 6MWD (95.4% versus 93.9%; p<0.05). On the contrary, global function in the group of controls was homogeneously decreased (FEV(1) and PEF p<0.01) after operation. The comparison of treated and untreated patients 1 month after the operation did not show any significant difference in terms of FEV(1), FVC, PEF, distance, Hb saturation, and KCO that instead were homogeneously and significantly worse at baseline (before the surgical operation) in the case group.


CONCLUSIONS
Respiratory Function and exercise capacity significantly improve following a post-operative 4-week i-PR in lung resected patients. i-PR could be regarded as a component of the management of patients who have undergone LR for cancer.
Cesario
Alfredo
A
Department of Surgical Sciences, Division of Thoracic Surgery, Catholic University, Rome.
Ferri
Luigi
L
Galetta
Domenico
D
Pasqua
Franco
F
Bonassi
Stefano
S
Clini
Enrico
E
Biscione
Gianluca
G
Cardaci
Vittorio
V
di Toro
Stefania
S
Zarzana
Alessia
A
Margaritora
Stefano
S
Piraino
Alessio
A
Russo
Patrizia
P
Sterzi
Silvia
S
Granone
Pierluigi
P
D002289:Carcinoma, Non-Small-Cell Lung; D004417:Dyspnea / Q000209:etiology / Q000503:physiopathology; D005500:Follow-Up Studies; D005541:Forced Expiratory Volume; D006801:Humans; D008175:Lung Neoplasms / Q000503:physiopathology / Q000534:rehabilitation* / Q000601:surgery*; D011013:Pneumonectomy; D011184:Postoperative Period; D011659:Pulmonary Gas Exchange; D012189:Retrospective Studies; D013147:Spirometry; D015996:Survival Rate; D013997:Time Factors; D016138:Walking