Critically appraised paper: Short-term preoperative exercise training improves exercise capacity and reduces postoperative pulmonary complications in people undergoing lung cancer surgery [commentary]

Abstract Background Abdominal cancer surgeries have a high incidence of postoperative complications. One strategy to prevent postoperative complications is preoperative exercise training. There are no systematic reviews that have compared the effects of preoperative exercise training programs of different length, frequency and duration on pre and postoperative clinical outcomes as well as on length of hospital stay (LOS) and in-hospital and late mortality in people with abdominal cancer. Methods Searches for randomised controlled trials (RCTs) of preoperative exercise training for people undergoing major surgery for abdominal cancer will be conducted in Pubmed, EMBASE, PEDro (Physiotherapy Evidence Database) and the Cochrane Library. There will be no restrictions on the language or date of publication in the search. The primary outcomes of the systematic review will be incidence of postoperative pulmonary complications as well as post-intervention and postoperative exercise capacity. The risk of bias of included RCTs will be assessed using the PEDro scale. The quality of evidence will be rated using the GRADE system (Grading of Recommendations Assessment, Development and Evaluation). Subgroup analyzes will be conducted based on: intervention performed with or without supervision; types of exercises; and frequency and duration of the intervention. Discussion Our hypothesis is that preoperative exercise training will reduce the incidence of postoperative pulmonary complications in people undergoing major surgery for abdominal cancer by improving their preoperative exercise capacity. We will also explore the effects of the program on LOS and mortality. Systematic review registration: This systematic review protocol was registered with PROSPERO (Prospective International Register of Systematic Reviews) (number CRD42020199765).

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Faculty Opinions recommendation of Prevalence of and risk factors for postoperative pulmonary complications after lung cancer surgery in patients with early-stage COPD.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.734426009.793556198 ◽

2019 ◽

Author(s):

Matthias Eikermann

Keyword(s):

Risk Factors ◽

Lung Cancer ◽

Early Stage ◽

Lung Cancer Surgery ◽

Pulmonary Complications ◽

Cancer Surgery ◽

Postoperative Pulmonary Complications

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Lung Cancer Surgery in Patients with Chronic Obstructive Pulmonary Disease (COPD): Surgical Selection Challenges and Clinical Outcomes

Current Respiratory Medicine Reviews ◽

10.2174/1573398x15666190531104506 ◽

2019 ◽

Vol 15 (2) ◽

pp. 140-146 ◽

Cited By ~ 1

Author(s):

Georgia Hardavella ◽

Ioannis Karampinis ◽

Panagiota Styliara ◽

Ilias Kainis

Keyword(s):

Lung Cancer ◽

Clinical Outcomes ◽

Health Care Systems ◽

Treatment Options ◽

Lung Cancer Surgery ◽

Pulmonary Complications ◽

Cancer Surgery ◽

Chronic Obstructive ◽

Postoperative Pulmonary Complications ◽

Patient Consent

Health care systems worldwide are commonly burdened with COPD and lung cancer and subsequently much has been studied and learnt of the interdependence between these two clinical entities. Lung cancer surgical treatment options in patients with severe COPD remain a clinical challenge for the multidisciplinary team. Appropriate patient selection and prediction of postoperative pulmonary complications aid in surgical decision making and informed patient consent. In this review, we present an overview of surgical selection tools (lung function parameters, risk stratification for postoperative pulmonary complications) and lung cancer clinical outcomes (recurrence, survival) in patients with COPD undergoing lung cancer surgery.

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