Journal of cardiothoracic surgery · 2026
Effect of preoperative respiratory prehabilitation on cardiopulmonary function in patients undergoing lung resection for non-small cell lung cancer: a randomized controlled trial.
СтатьяРандомизированное исследованиеНазвание и аннотация: Перевод в очереди
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Huang Feiyan, Kong Pengxu, Liu Jingjing, Wang Caina, Xia Pinghui, Pan Limin, Jin Yali, Hu Hongyue, Zhang Xuan
Аннотация
BACKGROUND: Preoperative respiratory prehabilitation has attracted increasing attention as a perioperative strategy in thoracic surgery, but evidence regarding its short-term effects on early postoperative functional recovery remains limited. This randomized controlled trial investigated the effect of a 7-day preoperative respiratory prehabilitation program on postoperative pulmonary function, cardiopulmonary exercise capacity, and postoperative complications in patients undergoing curative-intent lung resection for non-small cell lung cancer (NSCLC).
METHODS: This single-center exploratory randomized controlled trial enrolled 120 patients with suspected NSCLC who were scheduled to undergo curative-intent anatomical lobectomy or wedge resection between January 2025 and November 2025. Patients were randomly assigned in a 1:1 ratio to routine perioperative care alone (control group, n = 60) or routine perioperative care plus a 7-day preoperative respiratory prehabilitation program (intervention group, n = 60). The primary endpoint was pulmonary function on postoperative day 7, assessed by forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), and peak expiratory flow (PEF). Secondary endpoints included within-group preoperative pulmonary function change in the intervention group, cardiopulmonary exercise capacity on postoperative day 7, and postoperative complications.
RESULTS: Baseline characteristics were generally comparable between the two groups. In the intervention group, FEV1, FVC, and PEF were all significantly higher 1 day before surgery than before training (all P < 0.001). At admission, no significant between-group differences were observed in pulmonary function. On postoperative day 7, the intervention group had significantly higher FEV1 (1.86 ± 0.64 vs. 1.55 ± 0.48 L, P = 0.003), FVC (2.30 ± 0.58 vs. 1.78 ± 0.42 L, P < 0.001), and PEF (4.50 ± 0.67 vs. 3.85 ± 0.64 L/s, P < 0.001) than the control group. Cardiopulmonary exercise variables were also higher in the intervention group, including VO2max, VO2/kg, anaerobic threshold, and O2 pulse (all P < 0.001). The postoperative complication rate was numerically lower in the intervention group than in the control group (6.67% vs. 18.33%), although this difference should be interpreted cautiously (P = 0.053).
CONCLUSIONS: In this single-center exploratory randomized trial, short-term preoperative respiratory prehabilitation was associated with better pulmonary function and cardiopulmonary exercise capacity on postoperative day 7 in patients undergoing curative-intent lung resection for NSCLC. These findings suggest that short-term respiratory prehabilitation may be a feasible perioperative strategy to support early postoperative functional recovery.
TRIAL REGISTRATION: Medical Research Registration and Record Information System of the National Healthcare Security Information Platform, MR-33-25-019022.
METHODS: This single-center exploratory randomized controlled trial enrolled 120 patients with suspected NSCLC who were scheduled to undergo curative-intent anatomical lobectomy or wedge resection between January 2025 and November 2025. Patients were randomly assigned in a 1:1 ratio to routine perioperative care alone (control group, n = 60) or routine perioperative care plus a 7-day preoperative respiratory prehabilitation program (intervention group, n = 60). The primary endpoint was pulmonary function on postoperative day 7, assessed by forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), and peak expiratory flow (PEF). Secondary endpoints included within-group preoperative pulmonary function change in the intervention group, cardiopulmonary exercise capacity on postoperative day 7, and postoperative complications.
RESULTS: Baseline characteristics were generally comparable between the two groups. In the intervention group, FEV1, FVC, and PEF were all significantly higher 1 day before surgery than before training (all P < 0.001). At admission, no significant between-group differences were observed in pulmonary function. On postoperative day 7, the intervention group had significantly higher FEV1 (1.86 ± 0.64 vs. 1.55 ± 0.48 L, P = 0.003), FVC (2.30 ± 0.58 vs. 1.78 ± 0.42 L, P < 0.001), and PEF (4.50 ± 0.67 vs. 3.85 ± 0.64 L/s, P < 0.001) than the control group. Cardiopulmonary exercise variables were also higher in the intervention group, including VO2max, VO2/kg, anaerobic threshold, and O2 pulse (all P < 0.001). The postoperative complication rate was numerically lower in the intervention group than in the control group (6.67% vs. 18.33%), although this difference should be interpreted cautiously (P = 0.053).
CONCLUSIONS: In this single-center exploratory randomized trial, short-term preoperative respiratory prehabilitation was associated with better pulmonary function and cardiopulmonary exercise capacity on postoperative day 7 in patients undergoing curative-intent lung resection for NSCLC. These findings suggest that short-term respiratory prehabilitation may be a feasible perioperative strategy to support early postoperative functional recovery.
TRIAL REGISTRATION: Medical Research Registration and Record Information System of the National Healthcare Security Information Platform, MR-33-25-019022.