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Patient education, Pre-Operative Optimization

The Benefits of Exercise in Thoracic Patients

There’s an article ( Jones et. al 2010) on the benefits of pre-operative and post-operative exercise regimens for patients with lung cancer, that was conducted down at Duke. They use a lot of abbreviations in the article, but the gist is that a patient’s post-operative risk can be determined by their peak oxygen consumption (which is measurable), and that this can be modified (improved) prior to surgery with a targeted fitness program. This program notably included weight training in addition to aerobic exercise.

A systematic review was recently published (Feb 2011) looking at a compilation of these types of studies to give an overview of the preponderance of evidence by Granger et. al. This isn’t an open access article so I can’t post the link here – but I can link the abstract which is a short summary of his findings..

So basically Granger looked at the above mentioned study, and fifteen others – and drew limited conclusions.. He limited his conclusions to saying exercise was safe, and helpful in lung cancer patients and improved the ‘health related quality of life’. It’s a bit different from what Jones had to say – but the message is the same; exercise is not only safe for lung cancer patients – but improves quality of life, and may (according to Jones) improve post-operative outcomes..

Nagarajan et al. (2011) reviewed several published papers on the topic of pulmonary rehabilitation in an effort to answer the questions of whether pre-operative pulmonary rehabilitation reduced post-operative complications & overall length of stay.  While they were unable to conclusively answer these questions – they did find that pre-operative pulmonary rehabilitation increased exercise capacity, and preserved pulmonary function in patients with COPD.  This may not sound important – until you realize that these are critical measures of quality of life. (for example – what if “increased exercise capacity” means a person can now walk to around their home, and perform daily activities of living such as showering and getting dressed without becoming short of breath?)

About K Eckland

World of Thoracic Surgery is a blog about the work, research, and practices of thoracic surgeons around the world. It includes case studies, [sometimes] dry research, interviews with thoracic surgeons along with patient perspectives, and feedback.

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