title: Preoperative pulmonary rehabilitation for marginal-function lung cancer patients.
abstract: Background This study aimed to evaluate the impact of preoperative pulmonary rehabilitation in lung cancer patients undergoing pulmonary resection surgery with marginal lung function. Methods Short-term outcomes of 42 patients with forced expiratory volume in 1 s < 1.6 L who underwent lung resection between 01/2006 and 12/2010 were reviewed retrospectively. They were divided into group A (no preoperative pulmonary rehabilitation) and group B (receiving pulmonary rehabilitation). In group B, a second set of pulmonary function tests was obtained. Results There were no significant differences in terms of sex, age, race, pathologic stage, operative procedure, or smoking years. Mean forced expiratory volume in 1 s and diffusing capacity for carbon monoxide in group A was 1.40 ± 0.22 L and 10.28 ± 2.64 g∙dL-1vs. 1.39 ± 0.13 L and 10.75 ± 2.08 g∙dL-1in group B. Group B showed significant improvement in forced expiratory volume in 1 s from 1.39 ± 0.13 to 1.55 ± 0.06 L ( p = 0.02). Mean intensive care unit stay was 6 ± 5 days in group A vs. 9 ± 9 days in group B ( p = 0.22). Mean hospital stay was 10 ± 4 days in group A vs. 14 ± 9 days in group B ( p = 0.31). There was no significant difference in morbidity or mortality between groups. Conclusion Preoperative pulmonary rehabilitation can significantly improve forced expiratory volume in 1 s in some marginal patients undergoing lung cancer resection. However, it does not improve length of stay, morbidity, or mortality.
authors.affiliation: 1 Department of General Surgery, Wayne State University/Detroit Medical Center, Detroit, MI, USA.
authors.forename: Asra
authors.initials: A
authors.lastname: Hashmi
authors.affiliation: 2 Division of Cardiothoracic Surgery, Wayne State University/Detroit Medical Center, Detroit, MI, USA.
authors.forename: Frank A
authors.initials: FA
authors.lastname: Baciewicz
authors.affiliation: 3 Department of Internal Medicine (Critical Care and Pulmonary Medicine), Wayne State University/Detroit Medical Center, Detroit, MI, USA.
authors.forename: Ayman O
authors.initials: AO
authors.lastname: Soubani
authors.affiliation: 4 Department of Internal Medicine (Hematology/Oncology), Karmanos Cancer Institute, Detroit, MI, USA.
authors.forename: Shirish M
authors.initials: SM
authors.lastname: Gadgeel
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay; D008168:Lung / Q000503:physiopathology / Q000601:surgery*; D008175:Lung Neoplasms / Q000401:mortality / Q000503:physiopathology / Q000534:rehabilitation* / Q000601:surgery*; D008297:Male; D011013:Pneumonectomy / Q000009:adverse effects / Q000401:mortality; D011300:Preoperative Care / Q000379:methods*; D011653:Pulmonary Diffusing Capacity; D020127:Recovery of Function; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014797:Vital Capacity
keywords: Exercise therapy; Forced expiratory volume; Lung neoplasms; Preoperative care; Treatment outcome