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a Section of Thoracic Surgery, Department of Surgical Sciences, University Hospital of Parma, Parma, Italy
b Section of Respiratory Diseases, Department of Clinical Sciences, University Hospital of Parma, Viale Gramsci 14, 43100 Parma, Italy
Received 21 June 2007; received in revised form 28 September 2007; accepted 3 October 2007.
* Corresponding author. Address: U.O. Chirurgia Toracica, Azienda Ospedaliera-Università di Parma, Viale Gramsci 14, 43100 Parma, Italy. Tel.: +39 03406874733; fax: +39 0521 992019. (Email: antonio.bobbio{at}unipr.it; antonboa{at}hotmail.com).
Background: The impact of short-term preoperative pulmonary rehabilitation on exercise capacity of patients with chronic obstructive pulmonary disease undergoing lobectomy for non-small cell lung cancer is evaluated. Methods: A prospective observational study was designed. Inclusion criteria consisted of an indication to lung resection because of a clinical stage I or II non-small cell lung cancer and a chronic obstructive disease on preoperative pulmonary function test. In such conditions, maximal oxygen consumption by a cardio-pulmonary exercise test was evaluated; when this resulted as being
15 ml/kg/min a pulmonary rehabilitation programme lasting 4 weeks was considered. Twelve patients fulfilled inclusion criteria, completed the preoperative rehabilitation programme and underwent a new functional evaluation prior to surgery. The postoperative record of these patients was collected. Results: On completion of pulmonary rehabilitation, the resting pulmonary function test and diffuse lung capacity of patients was unchanged, whereas the exercise performance was found to have significantly improved; the mean increase in maximal oxygen consumption proved to be at 2.8 ml/kg/min (p
< 0.01). Eleven patients underwent lobectomy; no postoperative mortality was noted and mean hospital stay was 17 days. Postoperative pulmonary complication was recorded in 8 patients. Conclusions: Short-term preoperative pulmonary rehabilitation could improve the exercise capacity of patients with chronic obstructive pulmonary disease who are candidates for lung resection for non-small cell lung cancer.
Key Words: Lung cancer surgery Preoperative care Surgery Complications
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