The clinical value of lung rehabilitation in the perioperative period of enhanced recovery after surgery_West China Medical Journal

Authors：

 CHE Guowei

Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

CHE Guowei, Email: guowei_che@yahoo.com

Keywords：

Enhanced recovery after surgery; Pulmonary rehabilitation; Perioperative period; Lung neoplasm

DOI：

10.7507/1002-0179.201710053

Video：

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The great clinical efficacy of an enhanced recovery after surgery (ERAS) program has been illustrated by the decreased incidence of perioperative complications and the shortened length of in-hospital stay. Furthermore, the ERAS programs have their own key techniques and strategies in the clinical application to the unique diseases and operative modes. The key technology of an ERAS program is the minimally invasive surgery, which has been widely utilized in the surgical specialties. The main strategy in an ERAS program consists of the intensive pulmonary rehabilitation and optimal perioperative care that aim to improve the in-hospital outcomes of lung cancer patients who are considered at high surgical risk. Pulmonary rehabilitation is regarded as the mainstay of the ERAS strategies but its clinical protocols still remain less mature. The purpose of this overview is to summarize the current pulmonary rehabilitation programs in terms of the suitable crowd, the feasible protocols and the clinical significance.

Citation： CHE Guowei. The clinical value of lung rehabilitation in the perioperative period of enhanced recovery after surgery. West China Medical Journal, 2018, 33(1): 104-107. doi: 10.7507/1002-0179.201710053 Copy

1.	Gupta H, Ramanan B, Gupta PK, et al. Impact of COPD on postoperative outcomes: results from a national database. Chest, 2013, 143(6): 1599-1606.
2.	Agostini P, Cieslik H, Rathinam S, et al. Postoperative pulmonary complications following thoracic surgery: are there any modifiable risk factors?. Thorax, 2010, 65(9): 815-818.
3.	车国卫, 刘伦旭, 石应康. 加速康复外科临床应用现状与思考. 中国胸心血管外科临床杂志, 2016, 23(3): 211-215.
4.	Chesterfield-Thomas G, Goldsmith I. Impact of preoperative pulmonary rehabilitation on the thoracoscore of patients undergoing lung resection. Interact Cardiovasc Thorac Surg, 2016, 23(5): 729-732.
5.	Sebio Garcia R, Yáñez Brage MI, Giménez Moolhuyzen E, et al. Functional and postoperative outcomes after preoperative exercise training in patients with lung cancer: a systematic review and meta-analysis. Interact Cardiovasc Thorac Surg, 2016, 23(3): 486-497.
6.	Lai Y, Huang J, Yang M, et al. Seven-day intensive preoperative rehabilitation for elderly patients with lung cancer: a randomized controlled trial. J Surg Res, 2017, 209: 30-36.
7.	Licker M, Karenovics W, Diaper J, et al. Short-term preoperative high-intensity interval training in patients awaiting lung cancer surgery: a randomized controlled trial. J Thorac Oncol, 2017, 12(2): 323-333.
8.	车国卫, 刘伦旭, 周清华. 加速康复外科从理论到实践——我们还需要做什么?. 中国肺癌杂志, 2017, 20(4): 219-225.
9.	支修益, 何建行, 刘伦旭, 等. 多学科围手术期气道管理专家共识（2016 年版）. 中国胸心血管外科临床杂志, 2016, 23(7): 641-645.
10.	车国卫, 刘伦旭. 加速肺康复外科, 需要精准治疗吗?. 2017, 20(8): 549-552.
11.	Mei J, Liu L, Tang M, et al. Airway bacterial colonization in patients with non-small cell lung cancer and the alterations during the perioperative period. J Thorac Dis, 2014, 6(9): 1200-1208.
12.	Gao K, Yu PM, Su JH, et al. Cardiopulmonary exercise testing screening and pre-operative pulmonary rehabilitation reduce postoperative complications and improve fast-track recovery after lung cancer surgery: a study for 342 cases. Thoracic Cancer, 2015, 6(4): 443-449.
13.	苏建华, 喻鹏铭, 周渝斌, 等. 影响肺癌手术住院费用和快速康复的临床因素分析. 中国肺癌杂志, 2014, 17(7): 536-540.
14.	李鹏飞, 赖玉田, 周坤, 等. 应用 Clavien-Dindo 分级系统对肺癌患者术后并发症分级及危险因素分析. 中国肺癌杂志, 2017, 20(4): 264-271.
15.	鲍珊, 苏建华, 廖虎, 等. 合并慢性阻塞性肺病和手术方式对肺癌患者术后快速康复及治疗费用的影响. 中国胸心血管外科临床杂志, 2014, 21(1): 17-20.
16.	Taylor MD, Lapar DJ, Isbell JM, et al. Marginal pulmonary function should not preclude lobectomy in selected patients with non-small cell lung cancer. J Thorac Cardiovasc Surg, 2014, 147(2): 738-744.
17.	车国卫, 李为民, 刘伦旭. 快速肺康复需要围手术期流程优化. 中国胸心血管外科临床杂志, 2016, 23(3): 216-220.
18.	Li S, Zhou K, Du H, et al. Body surface area is a novel predictor for surgical complications following video-assisted thoracoscopic surgery for lung adenocarcinoma: a retrospective cohort study. BMC Surg, 2017, 17(1): 69.
19.	赖玉田, 苏建华, 杨梅, 等. 术前短期综合肺康复训练对肺癌合并轻中度慢性阻塞性肺病患者的影响: 一项前瞻性随机对照试验. 中国肺癌杂志, 2016, 19(11): 746-753.
20.	沈春辉, 梅龙勇, 喻鹏铭, 等. 术前肺康复对肺癌合并中-重度慢性阻塞性肺疾病患者运动耐力的影响. 中国胸心血管外科临床杂志, 2011, 18(6): 514-517.
21.	车国卫, 支修益. 肺癌合并慢性阻塞性肺疾病患者围手术期气道管理现状. 中国肺癌杂志, 2014, 17(12): 884-888.
22.	Lai Y, Su J, Qiu P, et al. Systematic short-term pulmonary rehabilitation before lung cancer lobectomy: a randomized trial. Interact Cardiovasc Thorac Surg, 2017, 25(3): 476-483.
23.	高珂, 赖玉田, 黄健, 等. 非小细胞肺癌患者术前肺康复训练前后血清肺表面活性蛋白 D (SP-D) 改变与术后肺部并发症相关性的随机对照试验. 中国胸心血管外科临床杂志, 2017, 24(5): 330-337.
24.	Huang J, Lai Y, Gao K, et al. Surfactant protein-D: a sensitive predictor for efficiency of preoperative pulmonary rehabilitation. Int J Surg, 2017, 41: 136-142.
25.	周坤, 吴砚铭, 苏建华, 等. 肺癌患者术前呼气峰流速可以预测肺叶切除术后肺部并发症吗?. 中国肺癌杂志, 2017, 20(9): 603-609.
26.	Hashmi A, Baciewicz FJ, Soubani AO, et al. Preoperative pulmonary rehabilitation for marginal-function lung cancer patients. Asian Cardiovasc Thorac Ann, 2017, 25(1): 47-51.
27.	杜娜, 郭成林, 杨梅, 等. 加速康复外科在中国大陆胸外科临床现状——基于胸外科医生及护士调查分析. 中国肺癌杂志, 2017, 20(3): 157-162.
28.	Rivas-Perez H, Nana-Sinkam P. Integrating pulmonary rehabilitation into the multidisciplinary management of lung cancer: a review. Respir Med, 2015, 109(4): 437-442.
29.	赖玉田, 田龙, 樊骏, 等. 肺癌住院手术患者临床特征与就诊模式的关系. 中国肺癌杂志, 2015, 18(7): 457-461.

1. Gupta H, Ramanan B, Gupta PK, et al. Impact of COPD on postoperative outcomes: results from a national database. Chest, 2013, 143(6): 1599-1606.
2. Agostini P, Cieslik H, Rathinam S, et al. Postoperative pulmonary complications following thoracic surgery: are there any modifiable risk factors?. Thorax, 2010, 65(9): 815-818.
3. 车国卫, 刘伦旭, 石应康. 加速康复外科临床应用现状与思考. 中国胸心血管外科临床杂志, 2016, 23(3): 211-215.
4. Chesterfield-Thomas G, Goldsmith I. Impact of preoperative pulmonary rehabilitation on the thoracoscore of patients undergoing lung resection. Interact Cardiovasc Thorac Surg, 2016, 23(5): 729-732.
5. Sebio Garcia R, Yáñez Brage MI, Giménez Moolhuyzen E, et al. Functional and postoperative outcomes after preoperative exercise training in patients with lung cancer: a systematic review and meta-analysis. Interact Cardiovasc Thorac Surg, 2016, 23(3): 486-497.
6. Lai Y, Huang J, Yang M, et al. Seven-day intensive preoperative rehabilitation for elderly patients with lung cancer: a randomized controlled trial. J Surg Res, 2017, 209: 30-36.
7. Licker M, Karenovics W, Diaper J, et al. Short-term preoperative high-intensity interval training in patients awaiting lung cancer surgery: a randomized controlled trial. J Thorac Oncol, 2017, 12(2): 323-333.
8. 车国卫, 刘伦旭, 周清华. 加速康复外科从理论到实践——我们还需要做什么?. 中国肺癌杂志, 2017, 20(4): 219-225.
9. 支修益, 何建行, 刘伦旭, 等. 多学科围手术期气道管理专家共识（2016 年版）. 中国胸心血管外科临床杂志, 2016, 23(7): 641-645.
10. 车国卫, 刘伦旭. 加速肺康复外科, 需要精准治疗吗?. 2017, 20(8): 549-552.
11. Mei J, Liu L, Tang M, et al. Airway bacterial colonization in patients with non-small cell lung cancer and the alterations during the perioperative period. J Thorac Dis, 2014, 6(9): 1200-1208.
12. Gao K, Yu PM, Su JH, et al. Cardiopulmonary exercise testing screening and pre-operative pulmonary rehabilitation reduce postoperative complications and improve fast-track recovery after lung cancer surgery: a study for 342 cases. Thoracic Cancer, 2015, 6(4): 443-449.
13. 苏建华, 喻鹏铭, 周渝斌, 等. 影响肺癌手术住院费用和快速康复的临床因素分析. 中国肺癌杂志, 2014, 17(7): 536-540.
14. 李鹏飞, 赖玉田, 周坤, 等. 应用 Clavien-Dindo 分级系统对肺癌患者术后并发症分级及危险因素分析. 中国肺癌杂志, 2017, 20(4): 264-271.
15. 鲍珊, 苏建华, 廖虎, 等. 合并慢性阻塞性肺病和手术方式对肺癌患者术后快速康复及治疗费用的影响. 中国胸心血管外科临床杂志, 2014, 21(1): 17-20.
16. Taylor MD, Lapar DJ, Isbell JM, et al. Marginal pulmonary function should not preclude lobectomy in selected patients with non-small cell lung cancer. J Thorac Cardiovasc Surg, 2014, 147(2): 738-744.
17. 车国卫, 李为民, 刘伦旭. 快速肺康复需要围手术期流程优化. 中国胸心血管外科临床杂志, 2016, 23(3): 216-220.
18. Li S, Zhou K, Du H, et al. Body surface area is a novel predictor for surgical complications following video-assisted thoracoscopic surgery for lung adenocarcinoma: a retrospective cohort study. BMC Surg, 2017, 17(1): 69.
19. 赖玉田, 苏建华, 杨梅, 等. 术前短期综合肺康复训练对肺癌合并轻中度慢性阻塞性肺病患者的影响: 一项前瞻性随机对照试验. 中国肺癌杂志, 2016, 19(11): 746-753.
20. 沈春辉, 梅龙勇, 喻鹏铭, 等. 术前肺康复对肺癌合并中-重度慢性阻塞性肺疾病患者运动耐力的影响. 中国胸心血管外科临床杂志, 2011, 18(6): 514-517.
21. 车国卫, 支修益. 肺癌合并慢性阻塞性肺疾病患者围手术期气道管理现状. 中国肺癌杂志, 2014, 17(12): 884-888.
22. Lai Y, Su J, Qiu P, et al. Systematic short-term pulmonary rehabilitation before lung cancer lobectomy: a randomized trial. Interact Cardiovasc Thorac Surg, 2017, 25(3): 476-483.
23. 高珂, 赖玉田, 黄健, 等. 非小细胞肺癌患者术前肺康复训练前后血清肺表面活性蛋白 D (SP-D) 改变与术后肺部并发症相关性的随机对照试验. 中国胸心血管外科临床杂志, 2017, 24(5): 330-337.
24. Huang J, Lai Y, Gao K, et al. Surfactant protein-D: a sensitive predictor for efficiency of preoperative pulmonary rehabilitation. Int J Surg, 2017, 41: 136-142.
25. 周坤, 吴砚铭, 苏建华, 等. 肺癌患者术前呼气峰流速可以预测肺叶切除术后肺部并发症吗?. 中国肺癌杂志, 2017, 20(9): 603-609.
26. Hashmi A, Baciewicz FJ, Soubani AO, et al. Preoperative pulmonary rehabilitation for marginal-function lung cancer patients. Asian Cardiovasc Thorac Ann, 2017, 25(1): 47-51.
27. 杜娜, 郭成林, 杨梅, 等. 加速康复外科在中国大陆胸外科临床现状——基于胸外科医生及护士调查分析. 中国肺癌杂志, 2017, 20(3): 157-162.
28. Rivas-Perez H, Nana-Sinkam P. Integrating pulmonary rehabilitation into the multidisciplinary management of lung cancer: a review. Respir Med, 2015, 109(4): 437-442.
29. 赖玉田, 田龙, 樊骏, 等. 肺癌住院手术患者临床特征与就诊模式的关系. 中国肺癌杂志, 2015, 18(7): 457-461.

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