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. 2016 Nov 19;11(1):443-448.
doi: 10.1515/med-2016-0079. eCollection 2016.

Preoperative high-intensity training in frail old patients undergoing pulmonary resection for NSCLC

Rosario Salvi #  1 , Ilernando Meoli #  2 , Antonio Cennamo  3 , Fabio Perrotta  3 , Francesco Saverio Cerqua  3 , Raffaele Montesano  3 , Carlo Curcio  1 , Francesco Lassandro  4 , Francesco Stefanelli  2 , Edoardo Grella  3 , Domenico Tafuri  5 , Gennaro Mazzarella  3 , Andrea Bianco  6
Affiliations

Preoperative high-intensity training in frail old patients undergoing pulmonary resection for NSCLC

Rosario Salvi et al. Open Med (Wars). .

Abstract

Thoracic surgery remains the better therapeutic option for non-small cell lung cancer patients that are diagnosed in early stage disease. Preoperative lung function assessment includes respiratory function tests (RFT) and cardio-pulmonary exercise testing (CPET). Vo2 peak, FEV1 and DLCO as well as recognition of performance status, presence of co-morbidities, frailty indexes, and age predict the potential impact of surgical resection on patient health status and survival risk. In this study we have retrospectively assessed the benefit of a high-intensity preoperative pulmonary rehabilitation program (PRP) in 14 patients with underlying lung function impairment prior to surgery. Amongst these, three patients candidate to surgical resection exhibited severe functional impairment associated with high score of frailty according CHS and SOF index, resulting in a substantial mortality risk. Our observations indicate that PRP appear to reduce the mortality and morbidity risk in frail patients with concurrent lung function impairment undergoing thoracic surgery. PRP produced improvement of VO2 peak degree and pulmonary function resulting in reduced postoperative complications in high-risk patients from our cases. Our results indicate that a preoperative training program may improve postoperative clinical outcomes in fraillung cancer patients with impaired lung function prior to surgical resection.

Keywords: Aging; Frail patients; Non-small cell lung cancer; Pulmonary rehabilitation program; Respiratory function tests; Thoracic Surgery.

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Conflict of interest statement

Conflict of Interests: The authors declare that they have no conflict of interests.

Figures

Figure 1
Figure 1
VATS lobectomy plus mediastinal linfadenectomy.
Figure 2
Figure 2
Lower left lobectomy in Thoracotomy.
See this image and copyright information in PMC

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