title: Influence of Pulmonary Rehabilitation on Lung Function Changes After the Lung Resection for Primary Lung Cancer in Patients with Chronic Obstructive Pulmonary Disease.
abstract: Influence of physiotherapy on the outcome of the lung resection is still controversial. Study aim was to assess the influence of physiotherapy program on postoperative lung function and effort tolerance in lung cancer patients with chronic obstructive pulmonary disease (COPD) that are undergoing lobectomy or pneumonectomy. The prospective study included 56 COPD patients who underwent lung resection for primary non small-cell lung cancer after previous physiotherapy (Group A) and 47 COPD patients (Group B) without physiotherapy before lung cancer surgery. In Group A, lung function and effort tolerance on admission were compared with the same parameters after preoperative physiotherapy. Both groups were compared in relation to lung function, effort tolerance and symptoms change after resection. In patients with tumors requiring a lobectomy, after preoperative physiotherapy, a highly significant increase in FEV1, VC, FEF50 and FEF25 of 20%, 17%, 18% and 16% respectively was registered with respect to baseline values. After physiotherapy, a significant improvement in 6-minute walking distance was achieved. After lung resection, the significant loss of FEV1 and VC occurred, together with significant worsening of the small airways function, effort tolerance and symptomatic status. After the surgery, a clear tendency existed towards smaller FEV1 loss in patients with moderate to severe, when compared to patients with mild baseline lung function impairment. A better FEV1 improvement was associated with more significant loss in FEV1. Physiotherapy represents an important part of preoperative and postoperative treatment in COPD patients undergoing a lung resection for primary lung cancer.
authors.affiliation: 1 Clinic for Physical Medicine and Rehabilitation, Clinical Center of Serbia, Belgrade, Serbia ; 2 Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
authors.forename: Natasa
authors.initials: N
authors.lastname: Mujovic
authors.affiliation: 2 Faculty of Medicine, University of Belgrade, Belgrade, Serbia ; 3 Clinic for Cardiology, Clinical Center of Serbia, Belgrade, Serbia.
authors.forename: Nebojsa
authors.initials: N
authors.lastname: Mujovic
authors.affiliation: 2 Faculty of Medicine, University of Belgrade, Belgrade, Serbia ; 4 Clinic for Thoracic Surgery, Clinical Center of Serbia, Belgrade, Serbia.
authors.forename: Dragan
authors.initials: D
authors.lastname: Subotic
authors.affiliation: 2 Faculty of Medicine, University of Belgrade, Belgrade, Serbia ; 4 Clinic for Thoracic Surgery, Clinical Center of Serbia, Belgrade, Serbia.
authors.forename: Maja
authors.initials: M
authors.lastname: Ercegovac
authors.affiliation: 1 Clinic for Physical Medicine and Rehabilitation, Clinical Center of Serbia, Belgrade, Serbia ; 2 Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
authors.forename: Andjela
authors.initials: A
authors.lastname: Milovanovic
authors.affiliation: 5 Special Hospital for Cerebrovascular Disorders "Saint Sava", Belgrade, Serbia.
authors.forename: Ljubica
authors.initials: L
authors.lastname: Nikcevic
authors.affiliation: 2 Faculty of Medicine, University of Belgrade, Belgrade, Serbia ; 6Clinic for Pulmonary disease and TB, Clinical Center of Serbia, Belgrade, Serbia.
authors.forename: Vladimir
authors.initials: V
authors.lastname: Zugic
authors.affiliation: 2 Faculty of Medicine, University of Belgrade, Belgrade, Serbia ; 7 Department of Physical Medicine and Rehabilitation, University Children's Hospital, Belgrade, Serbia.
authors.forename: Dejan
authors.initials: D
authors.lastname: Nikolic
keywords: lobectomy; lung cancer; pneumonectomy; preoperative physiotherapy; pulmonary rehabilitation