Functional evaluation before lung resection: searching for a low technology test in a safer environment for the patient: a pilot study†

Novoa, Nuria; Esteban, P; Rodríguez, María; Gómez, María Teresa; Varela, Gonzálo

doi:10.1093/ejcts/ezw403

Cited by 5 publications

(3 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…To improve risk control, some teams prefer the use of ergocycle in a secured environment. 36 As SCT is a highly demanding cardiorespiratory test, there are associated risks. 37 It can identify patients presenting risks, but it is difficult to determine if the risk is cardiac, respiratory and/or neuromuscular.…”

Section: Discussionmentioning

confidence: 99%

Performance at stair-climbing test is associated with postoperative complications after lung resection: a systematic review and meta-analysis

Boujibar

Gillibert²,

Gravier

et al. 2020

Thorax

View full text Add to dashboard Cite

BackgroundThoracic surgery is the optimal treatment for early-stage lung cancer, but there is a high risk of postoperative morbidity. Therefore, it is necessary to evaluate patients’ preoperative general condition and cardiorespiratory capacity to determine the risk of postoperative complications. The objective of this study was to assess whether the stair-climbing test could be used in the preoperative evaluation of lung resection patients to predict postoperative morbidity following thoracic surgery.MethodsWe performed a systematic review and a meta-analysis on the association between stair-climbing test result and morbidity/mortality after thoracic surgery. We analysed all articles published until May 2020 in the following databases: Pubmed/Medline, Pedro, The Cochrane library, Embase and CINAHL. The risk of bias was assessed using the Quality in Prognosis Studies tool. This meta-analysis is registered as PROSPERO CRD42019121348.Results13 articles were included in the systematic review for a total of 2038 patients and 6 in the meta-analysis. There were multiple test evaluation criteria: rise time, height, desaturation and heart rate change. For the meta-analysis, we were able to pool data on the height of rise at a variable threshold: risk ratio 2.34 (95% CI 1.59 to 3.43) with I²=53% (p=0.06). The threshold for occurrence of complications was estimated at a 10 m climb.ConclusionsOur results indicate that the stair-climbing test could be used as a first-line functional screening test to predict postoperative morbidity following thoracic surgery and that patients with a poor test result (<10 m) should be referred to formal cardiopulmonary exercise testing.

show abstract

Section: Discussionmentioning

confidence: 99%

Performance at stair-climbing test is associated with postoperative complications after lung resection: a systematic review and meta-analysis

Boujibar

Gillibert²,

Gravier

et al. 2020

Thorax

View full text Add to dashboard Cite

show abstract

“…In addition to the inherent limitations of the retrospective study, unrepeatability, safety guarantee, and difficulty in standardization in the implementation of SCT should be taken into full consideration. 22) …”

Section: Discussionmentioning

confidence: 99%

The Predictive Value of Stair Climbing Test on Postoperative Complications in Lung Cancer Patients with Limited Pulmonary Function

Xiao

Shao

Zhang

et al. 2022

ATCS

View full text Add to dashboard Cite

Purpose: To evaluate the predictive value of stair climbing test (SCT) on postoperative complications in lung cancer patients with limited pulmonary function. Methods: A total of 727 hospitalized lung cancer patients with limited pulmonary function were retrospectively reviewed. Included in the cohort were 424 patients who underwent SCT preoperatively. Patients were grouped according to general condition, past medical history, surgical approach, pulmonary function test, and SCT results. Comparison of the postoperative cardiopulmonary complication rates was made and independent risk factors were identified. Results: A total of 89 cardiopulmonary-related complications occurred in 69 cases, accounting for 16.3% of the entire cohort. The postoperative cardiopulmonary complication rates were significantly different between groups stratified by smoking index, percentage of forced expiratory volume in one second, percentage of diffusion capacity for carbon monoxide, SCT results, excision extension, and anesthetic duration (p <0.05). Multivariate analysis showed that only height achieved (p <0.001), changes in heart rate (∆HR; p <0.001), and excision extension (p = 0.006) were independent risk factors for postoperative cardiopulmonary complications. Conclusions: The SCT could be used as a preoperative screening method for lung cancer patients with limited pulmonary function. For those patients who could only climb less than 6 floors or had ∆HR >30 bpm in the test, sublobar resection should be selected to reduce the postoperative cardiopulmonary complication rate.

show abstract

“…Licker et al (15), based on the results of a study conducted on 1,222 patients who underwent pulmonary resection by mini-thoracotomy and divided into three groups (728 patients with FEV1 >70%; 397 patients with FEV1 between 50% and 70%; 97 patients with FEV1 <50%), showed that the risk of developing postoperative respiratory complications is greater in patients with reduced FEV1 (risk equal to 10%, 25% and 27% respectively in the three groups) and have calculated the reference cut-off value of FEV1 predictive of respiratory complications equal to 60%, under which value, the risk increases considerably. In the assessment of the respiratory reserve, in addition to FEV1, many authors consider other parameters such as postoperative predictive (ppo) FEV1 (ppo FEV1); DLCO and postoperative predictive DLCO (ppo DLCO) (13,16,17). According to the ACCP guidelines (13), if these values are >60%, patients are considered to be at low risk and, in these cases, pulmonary lobectomy or even pneumonectomy can be safely performed; in case of DLCO ranging from 30% to 60%, further tests such as the "stair climb test", the "shuttle walk test" or the calculation of the maximum volume of oxygen consumed in 1 minute (VO2max) should be considered.…”

Section: Original Articlementioning

confidence: 99%

Preoperative function evaluation of the major lung resection: muscle-sparing axillary mini-thoracotomy versus video-assisted thoracoscopic surgery

Divisi¹,

Zaccagna²,

Barone³

et al. 2018

Shanghai Chest

View full text Add to dashboard Cite

Background: In surgically fit non-small cell lung cancer (NSCLC) patients, pulmonary lobectomy still represents the standard of care. In recent years, the development of minimally invasive video-assisted techniques has reduced perioperative surgical stress, including patients previously thought to be unfit for surgery.Methods: We carried out a review of literature in order to evaluate the role of the preoperative parameters in functionally compromised patients and the effectiveness of video-assisted thoracoscopic surgery (VATS) compared to the "muscle sparing" axillary mini-thoracotomy in major lung resections.Results: Of 99 analyzed papers, we considered the 24 most significant, according to the preoperative functional status evaluation and, especially cardiac and respiratory reserve. Conclusions:In patients with a reduced cardio-respiratory function undergoing pulmonary resection, VATS guarantees results superimposable to mini-thoracotomy and represents a valid alternative to be taken into consideration.

show abstract

Functional evaluation before lung resection: searching for a low technology test in a safer environment for the patient: a pilot study†

Cited by 5 publications

References 14 publications

Performance at stair-climbing test is associated with postoperative complications after lung resection: a systematic review and meta-analysis

Performance at stair-climbing test is associated with postoperative complications after lung resection: a systematic review and meta-analysis

The Predictive Value of Stair Climbing Test on Postoperative Complications in Lung Cancer Patients with Limited Pulmonary Function

Preoperative function evaluation of the major lung resection: muscle-sparing axillary mini-thoracotomy versus video-assisted thoracoscopic surgery

Contact Info

Product

Resources

About