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.	車國衛, 劉倫旭, 石應康. 加速康復外科臨床應用現狀與思考. 中國胸心血管外科臨床雜志, 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, Yá?ez 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.	車國衛, 劉倫旭, 周清華. 加速康復外科從理論到實踐——我們還需要做什么?. 中國肺癌雜志, 2017, 20(4): 219-225.
9.	支修益, 何建行, 劉倫旭, 等. 多學科圍手術期氣道管理專家共識（2016 年版）. 中國胸心血管外科臨床雜志, 2016, 23(7): 641-645.
10.	車國衛, 劉倫旭. 加速肺康復外科, 需要精準治療嗎?. 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.	蘇建華, 喻鵬銘, 周渝斌, 等. 影響肺癌手術住院費用和快速康復的臨床因素分析. 中國肺癌雜志, 2014, 17(7): 536-540.
14.	李鵬飛, 賴玉田, 周坤, 等. 應用 Clavien-Dindo 分級系統對肺癌患者術后并發癥分級及危險因素分析. 中國肺癌雜志, 2017, 20(4): 264-271.
15.	鮑珊, 蘇建華, 廖虎, 等. 合并慢性阻塞性肺病和手術方式對肺癌患者術后快速康復及治療費用的影響. 中國胸心血管外科臨床雜志, 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.	車國衛, 李為民, 劉倫旭. 快速肺康復需要圍手術期流程優化. 中國胸心血管外科臨床雜志, 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.	賴玉田, 蘇建華, 楊梅, 等. 術前短期綜合肺康復訓練對肺癌合并輕中度慢性阻塞性肺病患者的影響: 一項前瞻性隨機對照試驗. 中國肺癌雜志, 2016, 19(11): 746-753.
20.	沈春輝, 梅龍勇, 喻鵬銘, 等. 術前肺康復對肺癌合并中-重度慢性阻塞性肺疾病患者運動耐力的影響. 中國胸心血管外科臨床雜志, 2011, 18(6): 514-517.
21.	車國衛, 支修益. 肺癌合并慢性阻塞性肺疾病患者圍手術期氣道管理現狀. 中國肺癌雜志, 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, 賴玉田, 黃健, 等. 非小細胞肺癌患者術前肺康復訓練前后血清肺表面活性蛋白 D (SP-D) 改變與術后肺部并發癥相關性的隨機對照試驗. 中國胸心血管外科臨床雜志, 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, 吳硯銘, 蘇建華, 等. 肺癌患者術前呼氣峰流速可以預測肺葉切除術后肺部并發癥嗎?. 中國肺癌雜志, 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, 楊梅, 等. 加速康復外科在中國大陸胸外科臨床現狀——基于胸外科醫生及護士調查分析. 中國肺癌雜志, 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.	賴玉田, 田龍, 樊駿, 等. 肺癌住院手術患者臨床特征與就診模式的關系. 中國肺癌雜志, 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. 車國衛, 劉倫旭, 石應康. 加速康復外科臨床應用現狀與思考. 中國胸心血管外科臨床雜志, 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, Yá?ez 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. 車國衛, 劉倫旭, 周清華. 加速康復外科從理論到實踐——我們還需要做什么?. 中國肺癌雜志, 2017, 20(4): 219-225.
9. 支修益, 何建行, 劉倫旭, 等. 多學科圍手術期氣道管理專家共識（2016 年版）. 中國胸心血管外科臨床雜志, 2016, 23(7): 641-645.
10. 車國衛, 劉倫旭. 加速肺康復外科, 需要精準治療嗎?. 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. 蘇建華, 喻鵬銘, 周渝斌, 等. 影響肺癌手術住院費用和快速康復的臨床因素分析. 中國肺癌雜志, 2014, 17(7): 536-540.
14. 李鵬飛, 賴玉田, 周坤, 等. 應用 Clavien-Dindo 分級系統對肺癌患者術后并發癥分級及危險因素分析. 中國肺癌雜志, 2017, 20(4): 264-271.
15. 鮑珊, 蘇建華, 廖虎, 等. 合并慢性阻塞性肺病和手術方式對肺癌患者術后快速康復及治療費用的影響. 中國胸心血管外科臨床雜志, 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. 車國衛, 李為民, 劉倫旭. 快速肺康復需要圍手術期流程優化. 中國胸心血管外科臨床雜志, 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. 賴玉田, 蘇建華, 楊梅, 等. 術前短期綜合肺康復訓練對肺癌合并輕中度慢性阻塞性肺病患者的影響: 一項前瞻性隨機對照試驗. 中國肺癌雜志, 2016, 19(11): 746-753.
20. 沈春輝, 梅龍勇, 喻鵬銘, 等. 術前肺康復對肺癌合并中-重度慢性阻塞性肺疾病患者運動耐力的影響. 中國胸心血管外科臨床雜志, 2011, 18(6): 514-517.
21. 車國衛, 支修益. 肺癌合并慢性阻塞性肺疾病患者圍手術期氣道管理現狀. 中國肺癌雜志, 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, 賴玉田, 黃健, 等. 非小細胞肺癌患者術前肺康復訓練前后血清肺表面活性蛋白 D (SP-D) 改變與術后肺部并發癥相關性的隨機對照試驗. 中國胸心血管外科臨床雜志, 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, 吳硯銘, 蘇建華, 等. 肺癌患者術前呼氣峰流速可以預測肺葉切除術后肺部并發癥嗎?. 中國肺癌雜志, 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, 楊梅, 等. 加速康復外科在中國大陸胸外科臨床現狀——基于胸外科醫生及護士調查分析. 中國肺癌雜志, 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. 賴玉田, 田龍, 樊駿, 等. 肺癌住院手術患者臨床特征與就診模式的關系. 中國肺癌雜志, 2015, 18(7): 457-461.

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