Effectiveness of pulmonary rehabilitation and correlations in between functional parameters, extent of thoracic surgery and severity of post-operative complications: randomized clinical trial

Vágvölgyi, Attila; Rozgonyi, Zsolt; Kerti, Mária; Agathou, George; Vadász, P; Varga, János

doi:10.21037/jtd.2018.05.202

Cited by 44 publications

(61 citation statements)

References 20 publications

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“…Smoking has a huge impact on cardiopulmonary diseases and cancer (14). Based on our experience, the quitting rate can be much higher (70-75%) in perioperative condition (5,6).…”

Section: Smokingmentioning

confidence: 89%

“…We need to focus on functional and quality of life variables, which may help maximize surgery safety and improve the post-surgical period (3). There is still a debate in the preoperative risk stratification in thoracic surgery, including esophagectomy (4)(5)(6).…”

Section: Introductionmentioning

confidence: 99%

“…It lasts 2-3 weeks before surgery. The program contains respiratory training, learning controlled breathing techniques, chest mobilization, endurance training for the upper and lower extremities and cessation of smoking (5,6).…”

Section: Introductionmentioning

confidence: 99%

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Smoking and pulmonary complications: respiratory prehabilitation

Varga¹

2019

J. Thorac. Dis

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The severity of the clinical condition and co-morbidities of the patients for esophagectomy require a complex assessment and risk stratification before the operation, and most of the cases need complex management. We did a literature search and considered the data on risk stratification and complex management of patients who undergo thoracic surgery. Smoking cessation programs can protect against complications, which is related to the respiratory system, the heart and the convalescence of the wounds in postoperative condition, but the timing is critical due to the operation. A complex team of physicians and healthcare professionals, as well as respiratory prehabilitation, can help to improve the clinical condition, chest kinematics, lung mechanics, peripheral and respiratory muscle function, metabolism and quality of life of this type of patients. We need to consider a complex risk stratification before esophagectomy and require complex management for these patients, including smoking cessation and respiratory prehabilitation, to improve the post-operative complications.

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“…Smoking has a huge impact on cardiopulmonary diseases and cancer (14). Based on our experience, the quitting rate can be much higher (70-75%) in perioperative condition (5,6).…”

Section: Smokingmentioning

confidence: 89%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Smoking and pulmonary complications: respiratory prehabilitation

Varga¹

2019

J. Thorac. Dis

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“…According to the definition by the American Thoracic Society and the European Respiratory Society, PR refers to “a comprehensive intervention based on a thorough assessment of the patient followed by individualized treatment, including but not limited to exercise training, education, and behavior change, aimed at improving the physical and mental status of patients with CRDs and at promoting long-term adherence to health-enhancing behaviors” ( 17 ). Since the introduction of PR programs, reassuring results have been achieved in the treatment of CRDs, and health care providers have gradually realized that PR constitutes a pivotal basic measure in managing individuals with COPD ( 18 ).…”

Section: Introductionmentioning

confidence: 99%

Is it possible to reverse frailty in patients with chronic obstructive pulmonary disease?

Wang¹,

Hu²,

Dai³

2020

Clinics

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In recent years, frailty has attracted increasing attention from clinicians and health care workers. The influence of frailty on the elderly, especially those with chronic diseases of the respiratory system, is highly significant. Frailty is particularly more common in patients with chronic obstructive pulmonary disease (COPD). Frailty and COPD share many risk factors and pathophysiological mechanisms. As a comprehensive interventional method for chronic respiratory diseases, pulmonary rehabilitation is an important basic measure for the management of patients with COPD. Frailty in these patients can be reversed using pulmonary rehabilitation by targeting five components of the frailty phenotype at the entry point. The present review discusses the benefits of pulmonary rehabilitation in patients with COPD complicated by frailty and provides a theoretical basis for pulmonary rehabilitation treatment in this population. In addition, the timing of pulmonary rehabilitation is also addressed, with the prefrail stage being the “golden” period. The implementation of pulmonary rehabilitation must vary among individuals, and individualized treatment strategies will help maximize benefits.

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“…However, there are only few studies discussing the parameters affecting surgical complications. Attila Vagvolgyi et al 3 discussed that kilometers travelled via cycle ergometer at the onset of the preoperative rehabilitation, gender, forced expiratory volume in 1 s (FEV 1 ) after preoperative rehabilitation, extent of the operation and 6-minute walk test (6MWT) before preoperative rehabilitation could predict severe complications correctly in 72.5% of the patients with COPD who underwent thoracic surgery. Yutian LAI et al 4 demonstrated that preoperative COPD and WBC count were independent risk factors for postoperative cardio-pulmonary complications in the patients who underwent lobectomy for stage I non-small cell lung cancer.…”

Section: Introductionmentioning

confidence: 99%

Factors associated with the complications after lung surgery in the patients with early stage lung cancer: a preliminary study for preoperative pulmonary rehabilitation

Lee¹,

Byun²,

Ko³

2018

IPMRJ

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Patients with early stage lung cancer including stage I, II, and IIIA consider lung surgery as a treatment. Postoperative pulmonary complications, such as pneumonia, atelectasis, worsened gas exchange, bronchoconstriction, thromboembolic disease and respiratory failure, sometimes occur and they lead to admission of intensive care unit (ICU) and increased length of hospital stay. There have been previous studies discussing the effect of preoperative pulmonary rehabilitation in thoracic surgeries, and it is widely known that preoperative pulmonary rehabilitation could benefit the outcomes of thoracic surgery. However, there are only few studies discussing the parameters affecting surgical complications. The purpose of this study was to investigate factors associated with the complications after lung surgery in the patients with early stage lung cancer, to help decide the patients who need preoperative pulmonary rehabilitation. Medical record of patients with lung cancer of stage I who received operation in our hospital from March to June 2018 were reviewed, and the result of pulmonary function test (B=-2.03, p=0.00) and type of operation (B=-2.50, p=0.02) were shown to influence the length of hospital stay. According to the results, we conclude that these factors should be considered when deciding the need of preoperative pulmonary rehabilitation to reduce complications of the lung surgery.

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Effectiveness of pulmonary rehabilitation and correlations in between functional parameters, extent of thoracic surgery and severity of post-operative complications: randomized clinical trial

Abstract: Pulmonary rehabilitation can reduce the functional depletion caused by the thoracic surgical operation. Identification of more predictive factors of severe complications can help making preoperative risk stratification more precisely.

Cited by 44 publications

References 20 publications

Smoking and pulmonary complications: respiratory prehabilitation

Smoking and pulmonary complications: respiratory prehabilitation

Is it possible to reverse frailty in patients with chronic obstructive pulmonary disease?

Factors associated with the complications after lung surgery in the patients with early stage lung cancer: a preliminary study for preoperative pulmonary rehabilitation

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