title: Short-Term Preoperative High-Intensity Interval Training in Patients Awaiting Lung Cancer Surgery: A Randomized Controlled Trial.
abstract: Impairment in aerobic fitness is a potential modifiable risk factor for postoperative complications. In this randomized controlled trial, we hypothesized that a high-intensity interval training (HIIT) program enhances cardiorespiratory fitness before lung cancer surgery and therefore reduces the risk of postoperative complications.
  
  
  
  Patients with operable lung cancer were randomly assigned to usual care (UC) (n = 77) or preoperative rehabilitation based on HIIT (Rehab) (n = 74). Maximal cardiopulmonary exercise testing and the 6-minute walk test were performed twice before surgery. The primary outcome measure was a composite of death and in-hospital postoperative complications.
  
  
  
  The groups were well balanced in terms of patient characteristics. During the preoperative waiting period (median 25 days), the peak oxygen consumption and the 6-minute walking distance increased (median +15%, interquartile range, 25th to 75 percentile [IQR25%-75%, %] = +9% to +22%, p = 0.003 and +15%, IQR25%-75% = +8% to +28%, p < 0.001, respectively) in the Rehab group, whereas peak oxygen consumption declined in the UC group (median -8%, IQR25%-75% = -16% to 0%], p = 0.005). The primary end point did not differ significantly between the two groups: at least one postoperative complication developed in 27 of the 74 patients (35.5%) in the Rehab group and 39 of 77 patients (50.6%) in the UC group (p = 0.080). Notably, the incidence of pulmonary complications was lower in the Rehab compared with in the UC group (23% versus 44%, p = 0.018), owing to a significant reduction in atelectasis (12.2% versus 36.4%, p < 0.001), and this decrease was accompanied by a shorter length of stay in the postanesthesia care unit (median -7 hours, IQR25%-75% = -4 to -10).
  
  
  
  In this randomized controlled trial, preoperative HIIT resulted in significant improvement in aerobic performances but failed to reduce early complications after lung cancer resection.
authors: Department of Anesthesiology, Pharmacology and Intensive Care, University Hospital of Geneva, Geneva, Switzerland; Faculty of Medicine, University of Geneva, Geneva, Switzerland. Electronic address: marc-joseph.licker@hcuge.ch.
authors: Marc
authors: M
authors: Licker
authors: Division of Thoracic Surgery, University Hospital of Geneva, Geneva, Switzerland.
authors: Wolfram
authors: W
authors: Karenovics
authors: Department of Anesthesiology, Pharmacology and Intensive Care, University Hospital of Geneva, Geneva, Switzerland.
authors: John
authors: J
authors: Diaper
authors: Division of Internal Medicine, Hopital La Tour in Geneva, Geneva, Switzerland.
authors: Isabelle
authors: I
authors: Frésard
authors: Faculty of Medicine, University of Geneva, Geneva, Switzerland; Division of Thoracic Surgery, University Hospital of Geneva, Geneva, Switzerland.
authors: Frédéric
authors: F
authors: Triponez
authors: Department of Anesthesiology, Pharmacology and Intensive Care, University Hospital of Geneva, Geneva, Switzerland.
authors: Christoph
authors: C
authors: Ellenberger
authors: Department of Anesthesiology, Pharmacology and Intensive Care, University Hospital of Geneva, Geneva, Switzerland.
authors: Raoul
authors: R
authors: Schorer
authors: Institute of Sports Science and Department of Physiology at the Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland.
authors: Bengt
authors: B
authors: Kayser
authors: Faculty of Medicine, University of Geneva, Geneva, Switzerland; Division of Pneumology, Hospital du Valais in Sion, Sion, Switzerland.
authors: Pierre-Olivier
authors: PO
authors: Bridevaux
mesh_terms: D005081:Exercise Therapy; D005260:Female; D005500:Follow-Up Studies; D000072696:High-Intensity Interval Training; D006801:Humans; D008175:Lung Neoplasms / Q000534:rehabilitation* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011183:Postoperative Complications / Q000517:prevention & control*; D011300:Preoperative Care; D011379:Prognosis; D011446:Prospective Studies; D001261:Pulmonary Atelectasis / Q000517:prevention & control*
keywords: Aerobic capacity; Exercise training; Postoperative complications; Rehabilitation