Preoperative rehabilitation in patients undergoing pulmonary resections

Abstract

Introduction: Pulmonary resections result in permanent impairment of the respiratory function due to reduction of the gas-exchange surface. Most of these procedures are elective, which makes it possible to implement a preoperative rehabilitation programme, aimed at increasing general fitness, improving chest and diaphragm mobility, muscle strength and lung ventilation, and also at training the proper breathing pattern, effective coughing and pain-relief techniques. Improvement of patients' respiratory function and general fitness may contribute to the limitation of postoperative functional impairment, and therefore morbidity. Objectives: The aim of this systematic review was analysis of the effect of the preoperative rehabilitation on the postoperative course following pulmonary resections in lung cancer patients. Method: Systematic review of the literature published within the last 15 years was performed using PubMed and Worldcat databases. Methodological quality of selected papers was assessed using the PEDro scale. Results: Eight out of the 236 initially retrieved papers met the pre-set criteria, and search of the attached references found an additional 2 papers. In 9 of the papers included in the final analysis positive impact of the preoperative rehabilitation was shown, and no effect was found in one of them. There were no studies showing any negative effect of the preoperative rehabilitation. Conclusions: Preoperative rehabilitation may be beneficial, and its effects may last for several months after surgery. Rehabilitation programmes longer than 2 weeks were associated with functional improvement.