Effect of physical manipulation pulmonary rehabilitation on lung cancer patients after thoracoscopic lobectomy

Abstract

Background: To introduce a new postoperative pulmonary rehabilitation program named physical manipulation pulmonary rehabilitation (PMPR) and to explore the effect of perioperative management, including PMPR, on patients with non-small cell lung cancer (NSCLC) after thoracoscopic lobectomy. Methods: A randomized controlled trial was conducted between April and June 2021 at the Department of Thoracic Surgery, Beijing Hospital. Adult patients with NSCLC who had undergone thoracoscopic lobectomy were allocated to the treatment and control groups using a random number table. The treatment group received both conventional pulmonary rehabilitation (CVPR) and 14 days of PMPR after surgery; the control group patients received CVPR only. PMPR included relaxing and exercising the intercostal muscles, thoracic costal joint and abdominal breathing muscles. Pulmonary function tests and the 6-min walk test were conducted preoperatively and 7, 14, 21 and 28 days postoperatively. The postoperative length of hospital stay, chest tube retention time and postoperative pulmonary complications were recorded. The baseline data, pulmonary function parameters and prognosis were compared with t-and chi-square tests between the two groups. Results: A total of 86 patients were enrolled, and 44 patients were allocated to the treatment group. There were no significant differences in the baseline data for age, sex, body mass index, basic disease, surgical plan or preoperative pulmonary function between the two groups (all p > 0.05). The peak expiratory flow of patients in the treatment group was higher than that of those in the control group 21 days after surgery (316 AE 95 vs. 272 AE 103 l/min, respectively, p = 0.043), and forced expiratory volume in the first second on day 28 after surgery was greater than that in the control group (2.1 AE 0.2 vs. 1.9 AE 0.3 L, respectively, p < 0.001). There were no significant differences in forced vital capacity or 6-min walk test scores (both p > 0.05). There were no significant differences in the incidences of pneumonia and atelectasis between the two groups (both p > 0.05). The postoperative length of hospital stay (3.3 AE 1.3 vs. 3.9 AE 1.5 days, p = 0.043) and chest tube retention time (66 AE 30 vs. 81 AE 35 h, p = 0.036) in the treatment group were shorter than those in the control group. Conclusions: We determined that PMPR could improve early lung function in patients with NSCLC after thoracoscopic lobectomy, and that chest tube retention time and length of hospital stay were shortened.

Hydrogen-oxygen therapy improves postoperative pulmonary functions and accelerates recovery through attenuating inflammatory reactions and oxidative stress in patients undergoing lung surgery

“…Different approaches have been recommended to improve the rapid postoperative pulmonary function recovery [17,18], which is important to reduce the surgical complications and improve the patient's quality of life [19]. Previous studies have shown that the most serious postoperative pulmonary complications usually occur within 3 days after the operation [20,21].…”

Rapid Recovery of Postoperative Pulmonary Function in Patients With Lung Cancer and Influencing Factors

“…Cesario et al showed notable improvement in FEV1 at 1 month postoperatively with inhospital pulmonary rehabilitation than without pulmonary rehabilitation (2.32 Lt vs 1.79 Lt) (22). A randomized controlled trial by Zhou et al demonstrated higher FEV1 at 28 days postoperatively in patients receiving pulmonary rehabilitation than in the control group (54). A study on patients receiving thoracoscopic lobectomy or segmental resection by Zou et al found more notable improvement in pulmonary function at 3 months after hospital discharge in patients receiving pulmonary rehabilitation treatment (55).…”

“…A randomized controlled trial by Zhou et al. demonstrated higher FEV1 at 28 days postoperatively in patients receiving pulmonary rehabilitation than in the control group ( 54 ). A study on patients receiving thoracoscopic lobectomy or segmental resection by Zou et al.…”

Diaphragm Dysfunction and Rehabilitation Strategy in Patients With Chronic Obstructive Pulmonary Disease

“…Training the intercostal muscles could increase their strength, endurance and mobility, thereby improving their ability to resist high-load exercise and reducing the load on the diaphragm. Intercostal muscle training mostly adopts exercise that promote upper body activities, such as chest expansion, rotation, swimming and various ball games ( Zhou and Sun, 2021 ). Intercostal muscle training has high compliance requirements for patients and it is suitable for patients with mild to moderate COPD.…”