Preoperative high-intensity training in frail old patients undergoing pulmonary resection for NSCLC
Autor: | Francesco Saverio Cerqua, Rosario Salvi, Fabio Perrotta, Edoardo Grella, Andrea Bianco, Carlo Curcio, Antonio Cennamo, Gennaro Mazzarella, Domenico Tafuri, Francesco Lassandro, Raffaele Montesano, Ilernando Meoli, Francesco Stefanelli |
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Přispěvatelé: | Salvi, Rosario, Meoli, Ilernando, Cennamo, Antonio, Perrotta, Fabio, Saverio Cerqua, Francesco, Montesano, Raffaele, Curcio, Carlo, Lassandro, Francesco, Stefanelli, Francesco, Grella, Edoardo, Tafuri, Domenico, Mazzarella, Gennaro, Bianco, Andrea |
Jazyk: | angličtina |
Rok vydání: | 2016 |
Předmět: |
0301 basic medicine
medicine.medical_specialty Aging Frail patients Non-small cell lung cancer Pulmonary rehabilitation program Respiratory function tests Thoracic Surgery Medicine (all) pulmonary rehabilitation program medicine.medical_treatment Pulmonary function testing 03 medical and health sciences 0302 clinical medicine DLCO medicine Respiratory function Pulmonary rehabilitation Frail patient non-small cell lung cancer Old patients Performance status business.industry respiratory function tests frail patients aging Cancer General Medicine respiratory system medicine.disease thoracic surgery Surgery Respiratory function test 030104 developmental biology Cardiothoracic surgery 030220 oncology & carcinogenesis Medicine business Research Article |
Zdroj: | Open Medicine, Vol 11, Iss 1, Pp 443-448 (2016) Open Medicine |
ISSN: | 2391-5463 |
Popis: | 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. |
Databáze: | OpenAIRE |
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