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Randomized Controlled Trial
. 2025 Jun 18;33(7):593.
doi: 10.1007/s00520-025-09658-5.

Impact of preoperative respiratory training on early postoperative recovery in patients undergoing lung cancer surgery: a randomized controlled trial

Xue-E Su  1 , Wan-Ping Hong  1 , He-Fan He  1 , Baoyuan Xie  2 , Shan-Hu Wu  3
Affiliations
Randomized Controlled Trial

Impact of preoperative respiratory training on early postoperative recovery in patients undergoing lung cancer surgery: a randomized controlled trial

Xue-E Su et al. Support Care Cancer. .

Abstract

Background: Non-small cell lung cancer (NSCLC) patients undergoing video-assisted thoracoscopic surgery (VATS) lobectomy often face postoperative complications and delayed recovery. While preoperative smoking cessation and respiratory training are known to improve outcomes, the potential benefits of integrating traditional Chinese medicine (TCM) interventions, such as LIUZIJUE, remain underexplored.

Objective: This study aimed to evaluate the effects of preoperative respiratory training on perioperative outcomes in NSCLC patients undergoing VATS lobectomy, with a focus on peak expiratory flow (PEF), respiratory distress score (RPE), blood gas parameters, quality of recovery-15 (QOR-15), recovery room time, inflammatory markers (NLR, PLR), and postoperative complications.

Methods: A single-center randomized controlled trial was conducted at Fujian Medical University Affiliated Second Hospital from April 2023 to June 2024. Smokers requiring a 2-week cessation period before surgery were randomized into three groups: Control Group (CG, standard care), Intervention Group 1 (IG1, standard care plus device-based respiratory training), and Intervention Group 2 (IG2, standard care plus respiratory training and LIUZIJUE practice).

Results: The combined intervention group (IG2) demonstrated significant improvements in multiple postoperative outcomes, including PEF, QOR-15, RPE, and SpO2, outperforming both IG1 and CG. Subgroup analyses revealed that patients over 60 years old experienced more pronounced improvements in PEF, RPE, SpO2, and QOR-15 scores. Additionally, patients with comorbidities showed notable improvements in SpO2 and RPE, while those without comorbidities exhibited greater gains in SpO2, PEF, and QOR-15.

Conclusion: Preoperative respiratory training combined with LIUZIJUE significantly enhances postoperative recovery in NSCLC patients, with particularly marked benefits for older patients and those without comorbidities. These findings highlight the clinical potential of this intervention for broader application in perioperative care.

Keywords: Complications; Inflammatory markers; LIUZIJUE; Lobectomy; Non-small cell lung cancer; Quality of recovery; Respiratory training; Video-assisted thoracoscopic surgery.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: This single-blinded, randomized controlled trial was approved by the appropriate ethics committee (2021230) and was registered with the China Clinical Trials Registration Platform (ChiCTR2300069696). The trial followed the uniform standard guidelines for trial reporting, and the procedures were conducted in accordance with the ethical standards of the Declaration of Helsinki. All patients provided informed consent for their participation in the study. Consent for publication: The authors confirm that all individuals involved in the study have provided their consent for publication of the data and any identifying information included in this manuscript. Competing interests: The authors declare no competing interests.

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