The effects of physiotherapy on pulmonary function in COPD patients with primary lung cancer undergoing lung resection_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

 NI Gaoshun , CHEN Yang

Department of Respiratory Medicine, Shangluo Central Hospital, Shangluo, Shannxi 726000, P.R.China;

Corresponding?author：

NI Gaoshun, Email: nigaoshun688@163.com

Keywords：

Physiotherapy; Lung cancer; Chronic obstructive pulmonary disease; Lobectomy; Pneumonectomy

DOI：

10.7507/1671-6205.201611029

Video：

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Objective To assess the effects of physiotherapy on pulmonary function in COPD patients with lung cancer after lobectomy or pneumonectomy. Methods Fifty-five COPD patients with lung cancer undergoing lobectomy or pneumonectomy from January 2005 to May 2014 were recruited in the study. They were divided into group A received comprehensive physiotherapy before surgery and group B without comprehensive physiotherapy before surgery. The changes of lung function and tolerance were compared before physiotherapy (T1 time point) and after physiotherapy (T2 time point) in the group A, and between two groups before lung resection (T2 time point) and after lung resection (T3 time point). Results In group A, the forced expiratory volume in one second (FEV₁), vital capacity (VC), peak expiratory flow at 50% of vital capacity (FEF50) and FEF25 increased significantly respectively by 16.96%, 14.75%, 20.69% and 13.79% compared with those before physiotherapy. Meanwhile, six-minutes walking distance (6MWD) achieved a significant improvement. After resection of lung, FEV₁ and VC appeared to reduce, and pulmonary small airway function, tolerance, and clinical features deteriorated significantly. The differences between T2 and T1 in FEV₁, FEF50 and FEF25 in the patients with FEV₁%pred ≥80% and 50%-80% were similar with those in the patients with FEV₁%pred<50%. The differences between T2 and T3 in FEF50 and FEF25 in the patients with FEV₁%pred≥80% and 50%-80% were higher than those with FEV₁%pred<50%. For the patients with lobectomy, FEV₁ and VC in the group B were lower than those in the group A (FEV₁: 10.24% vs. 22.44%; VC: 10.13% vs. 20.87%). For the patients with pulmonary resection, FEV₁ and VC had little differences (FEV₁: 36.33% vs. 36.78%; VC: 37.23% vs. 38.98%). Conclusion Physiotherapy is very important for the preoperative treatment and postoperative nursing of COPD patients with primary lung cancer.

Citation： NI Gaoshun, CHEN Yang. The effects of physiotherapy on pulmonary function in COPD patients with primary lung cancer undergoing lung resection. Chinese Journal of Respiratory and Critical Care Medicine, 2017, 16(4): 318-323. doi: 10.7507/1671-6205.201611029 Copy

1.	Brunelli A, Charloux A, Bolliger CT, et al. The European Respiratory Society and European Society of Thoracic Surgeons clinical guidelines for evaluating fitness for radical treatment (surgery and chemoradiotherapy) in patients with lung cancer. Eur J Cardiothorac Surg, 2009, 36(1): 181-184.
2.	Yoshimoto K, Nomori H, Mori T, et al. Prediction of pulmonary function after lung lobectomy by subsegments counting, computed tomography, single photon emission computed tomography and computed tomography: a comparative study. Eur J Cardiothorac Surg, 2009, 35(3): 408-413.
3.	Schulte T, Schniewind B, Dohrmann P, et al. The extent of lung Parenchyma resection significantly impacts long-term quality of life in Patients with non-small cell lung cancer. Chest, 2009, 135(2) : 322-329.
4.	李飛霞, 林玉琴, 周麗華. 呼吸運動訓練對肺癌術后患者肺功能的影響. 中華現代護理雜志, 2010, 16(15): 1825-1826.
5.	Gomez M, Shamblin CJ, Silvestri GA. Preoperative Evaluation for Lung Cancer Resection. In: Lung Cancer Imaging. New York: Springer, 2013, 69-78.
6.	Mujovic N, Mujovic N, Subotic D, et al. Preoperative pulmonary rehabilitation in patients with non-small cell lung cancer and chronic obstructive pulmonary disease. Arch Med Sci, 2014, 10(1): 68-75.
7.	Ozalevli S, Ilgin D, Kul Karaali H, et al. The effect of in-patient chest physiotherapy in lung cancer patients. Support Care Cancer, 2010, 18(3): 351-358.
8.	崔石磊, 蔣偉平, 朱惠莉, 等. 上肢聯合下肢運動訓練對老年慢性阻塞性肺疾病穩定期患者運動心肺功能的影響. 中國呼吸與危重監護雜志, 2011, 10(2): 107-111.
9.	李哲, 楊三虎, 黃立軍, 等. 全肺切除術對非小細胞肺癌患者術后肺功能及生活質量影響的臨床研究. 中國現代手術學雜志, 2013, 17(2): 85-89.
10.	潘友民, 潘鐵成, 張良華, 等. 呼吸訓練改善肺癌患者手術后肺功能和生存質量的臨床研究. 中華物理醫學與康復雜志, 2005, 27(9): 548-550.
11.	Bobbio A, Chetta A, Ampollini L, et al. Preoperative pulmonary rehabilitation in patients undergoing lung resection for non-small cell lung cancer. Eur J Cardiothorac Surg, 2008, 33(1): 95-98.
12.	Liu W, Pan YL, Gao CX, et al. Breathing exercises improve post-operative pulmonary function and quality of life in patients with lung cancer: a meta-analysis. Exp Ther Med, 2013, 5(4): 1194-1200.
13.	Divisi D, Di Francesco C, Di Leonardo G, et al. Preoperative pulmonary rehabilitation in patients with lung cancer and chronic obstructive pulmonary disease. Eur J Cardiothorac Surg, 2013, 43(2): 293-296.
14.	Matsuo M, Hashimoto N, Usami N, et al. Inspiratory capacity as a preoperative assessment of patients undergoing thoracic surgery. Interact Cardiovasc Thorac Surg, 2012, 14(5): 560-564.
15.	Varela G, Brunelli A, Jiménez MF, et al. Chest drainage suction decreases differential pleural pressure after upper lobectomy and has no effect after lower lobectomy. Eur J Cardiothorac Surg, 2010, 37(3): 531-534.

1. Brunelli A, Charloux A, Bolliger CT, et al. The European Respiratory Society and European Society of Thoracic Surgeons clinical guidelines for evaluating fitness for radical treatment (surgery and chemoradiotherapy) in patients with lung cancer. Eur J Cardiothorac Surg, 2009, 36(1): 181-184.
2. Yoshimoto K, Nomori H, Mori T, et al. Prediction of pulmonary function after lung lobectomy by subsegments counting, computed tomography, single photon emission computed tomography and computed tomography: a comparative study. Eur J Cardiothorac Surg, 2009, 35(3): 408-413.
3. Schulte T, Schniewind B, Dohrmann P, et al. The extent of lung Parenchyma resection significantly impacts long-term quality of life in Patients with non-small cell lung cancer. Chest, 2009, 135(2) : 322-329.
4. 李飛霞, 林玉琴, 周麗華. 呼吸運動訓練對肺癌術后患者肺功能的影響. 中華現代護理雜志, 2010, 16(15): 1825-1826.
5. Gomez M, Shamblin CJ, Silvestri GA. Preoperative Evaluation for Lung Cancer Resection. In: Lung Cancer Imaging. New York: Springer, 2013, 69-78.
6. Mujovic N, Mujovic N, Subotic D, et al. Preoperative pulmonary rehabilitation in patients with non-small cell lung cancer and chronic obstructive pulmonary disease. Arch Med Sci, 2014, 10(1): 68-75.
7. Ozalevli S, Ilgin D, Kul Karaali H, et al. The effect of in-patient chest physiotherapy in lung cancer patients. Support Care Cancer, 2010, 18(3): 351-358.
8. 崔石磊, 蔣偉平, 朱惠莉, 等. 上肢聯合下肢運動訓練對老年慢性阻塞性肺疾病穩定期患者運動心肺功能的影響. 中國呼吸與危重監護雜志, 2011, 10(2): 107-111.
9. 李哲, 楊三虎, 黃立軍, 等. 全肺切除術對非小細胞肺癌患者術后肺功能及生活質量影響的臨床研究. 中國現代手術學雜志, 2013, 17(2): 85-89.
10. 潘友民, 潘鐵成, 張良華, 等. 呼吸訓練改善肺癌患者手術后肺功能和生存質量的臨床研究. 中華物理醫學與康復雜志, 2005, 27(9): 548-550.
11. Bobbio A, Chetta A, Ampollini L, et al. Preoperative pulmonary rehabilitation in patients undergoing lung resection for non-small cell lung cancer. Eur J Cardiothorac Surg, 2008, 33(1): 95-98.
12. Liu W, Pan YL, Gao CX, et al. Breathing exercises improve post-operative pulmonary function and quality of life in patients with lung cancer: a meta-analysis. Exp Ther Med, 2013, 5(4): 1194-1200.
13. Divisi D, Di Francesco C, Di Leonardo G, et al. Preoperative pulmonary rehabilitation in patients with lung cancer and chronic obstructive pulmonary disease. Eur J Cardiothorac Surg, 2013, 43(2): 293-296.
14. Matsuo M, Hashimoto N, Usami N, et al. Inspiratory capacity as a preoperative assessment of patients undergoing thoracic surgery. Interact Cardiovasc Thorac Surg, 2012, 14(5): 560-564.
15. Varela G, Brunelli A, Jiménez MF, et al. Chest drainage suction decreases differential pleural pressure after upper lobectomy and has no effect after lower lobectomy. Eur J Cardiothorac Surg, 2010, 37(3): 531-534.

Chinese Journal of Respiratory and Critical Care Medicine

The effects of physiotherapy on pulmonary function in COPD patients with primary lung cancer undergoing lung resection

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