| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Eur J Cardiothorac Surg 2006;29:266-267
© 2006 Elsevier Science NL
Letter to the Editor |
a Pulmonary Rehabilitation, IRCCS San Raffaele, Rome, Italy
b General Thoracic Surgery, Catholic University, Rome, Italy
c Clinical Respiratory Pathology Translational Laboratory, IRCCS San Raffaele, Rome, Italy
Received 9 November 2005; accepted 25 November 2005.
* Corresponding author: Tel.: +39 335 8366161; fax: +39 06 3051162. (Email: alfcesario{at}rm.unicatt.it).
Key Words: COPD • Lung cancer • Surgery • Pulmonary rehabilitation
We have read with interest the report from Bobbio et al. [1] regarding the changes in pulmonary function tests and cardio-pulmonary exercise capacity in patients affected by chronic obstructive pulmonary disease (COPD) who have undergone a lobar pulmonary resection.
Interestingly, the authors have demonstrated that COPD patients undergoing lobectomy may be found, 3 months after surgery, to have a persistent, significant exercise capacity loss in the absence of modifications of dynamic lung volumes (i.e. forced expiratory volume in 1 s—FEV1).
We would like to congratulate the authors for the extensive, precise and thoughtful analysis and would amicably invite them, on the basis of their experience, to briefly comment on the possible role of pulmonary rehabilitation (PR) in the post-operative status of lung-resected patients, eventually affected by COPD.
Nowadays, in fact, there is body of evidence regarding the efficacy of pulmonary rehabilitation in the comprehensive management of patients with COPD and PR programs are practiced worldwide [2].
Positive results in terms of improvement in dyspnoea, exercise capacity and quality of life (QoL) are recognised in chronic obstructive and non-obstructive pulmonary diseases, including COPD, cystic fibrosis and restrictive thoracic disease [3]. Moreover, PR is becoming a crucial component of the overall treating strategy in high-risk surgical patients (i.e. lung volume reduction surgery—LVRS and lung transplantation).
Particularly, PR was part of the preoperative phase in those candidates who met criteria for the large multicentre National Emphysema Treatment Trial (NETT) Research Group trial [4].
On the one hand, there are few data regarding the effectiveness of PR programs in the post-operative period of patients who have undergone lung resection (LR) for non-small cell lung cancer (NSCLC). On the other hand, thoracotomy and parenchymal resection "per se" are known to have an important effect on pulmonary function and QoL.
Our Group has a timely interest in this issue [5]: in our experience, we have substantially confirmed that an inpatient post-operative PR protocol improves significantly dyspnoea, exercise capacity and quality of life in patients who have undergone a parenchymal resection for cancer. As well we have confirmed that even if there is not a significant effect of PR on the dynamic lung volumes (FEV1) and blood gases values, the post-operative recovery of rehabilitated patients is more rapid in respect of those who have not been rehabilitated. Our updated evidence (data submitted for publication) further testifies that there is a possible beneficial role of post-operative PR following lung resection for NSCLC, in either COPD or non-COPD patients, especially in those cases with a poorer function at the moment of operation.
We would really appreciate an authors’ reply to these comments.
References
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |
