NSCLC: home-based prehabilitation improves function after VATS lobectomy

  • Liu Z & al.
  • Anesth Analg
  • 23 Jul 2019

  • curated by Kelli Whitlock Burton
  • Univadis Clinical Summaries
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Takeaway

  • A 2-week, home-based, multimodal prehabilitation program significantly improves functional capacity after video-assisted thoracoscopic surgery (VATS) lobectomy for NSCLC.
  • The preoperative program included exercise, respiratory training, nutrition supplement, and anxiety reduction.

Why this matters

  • Prior research suggests higher morbidity and mortality in patients with poor physical functional capacity after lung surgery.

Study design

  • Randomized controlled trial.
  • 73 patients with stage I-III NSCLC participated in a prehabilitation program (n=37) or received usual care (control group; n=36) before VATS lobectomy.
  • Funding: None.

Key results

  • At 30 days postsurgery, 6-minute walk distance (6MWD) was 21.5 m above baseline in the prehabilitation group, but declined by 36.1 m in the control group.
    • 89% of patients in the prehabilitation group vs 36% pf those in the control group performed the same or better vs baseline.
  • Prehabilitation improved perioperative 6MWD by 60.9 m vs the control group (P<.001>
  • Forced vital capacity (FVC) was significantly better in the prehabilitation group (mean difference between groups, 0.35 L; P=.021).
  • No significant differences between groups in postoperative complications, mortality, median length of stay, chest tube duration, disability, or lung function, except for FVC.

Limitations

  • Small sample size.

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