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Pulmonary rehabilitation programme for patients undergoing curative lung cancer surgery.

Bradley, Amy and Marshall, Andrea and Stonehewer, Louisa and Reaper, Lynn and Parker, Kim and Bevan-Smith, Elaine and Jordan, Chris and Gillies, James and Agostini, Paula and Bishay, Ehab and Kalkat, Maninder S and Steyn, Richard and Rajesh, Pala B and Dunn, Janet and Naidu, Babu V (2013) Pulmonary rehabilitation programme for patients undergoing curative lung cancer surgery. European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery, 44 (4). e266-71. ISSN 1873-734X.

Full text not available from this repository.
Official URL: http://ejcts.oxfordjournals.org/content/44/4/e266....

Abstract

OBJECTIVES

The aim of the study was to develop a multistranded pragmatic rehabilitation programme for operable lung cancer patients, that looks into feasibility, process indicators, outcome measures, local adaptability, compliance and potential cost benefit.

METHODS

An outpatient-based complex intervention, rehabilitation for operated lung cancer (ROC) programme, was developed to optimize physical status, prepare for the inpatient journey and support through recovery after surgery. It includes exercise classes, smoking cessation, dietary advice and patient education and was tested in an enriched cohort study within a regional thoracic unit over 18 months.

RESULTS

A multistranded pragmatic rehabilitation programme pre- and post-surgery is feasible. Fifty-eight patients received the intervention and 305 received standard care. Both groups were matched for age, lung function comorbidity and type of surgery. Patients in the intervention group attended exercise classes twice a week until surgery, which was not delayed. Patients attended four sessions presurgery (range 1-15), resulting in an improvement of 20 m (range -73-195, P = 0.001) in a 6-min walk test and 0.66 l in forced expiratory volume in 1 s (range -1.85 from 1.11, P = 0.009) from baseline to presurgery. Fifty-four percentage of smokers in the intervention group stopped smoking. Sixteen percentage of patients were identified as being at risk of malnourishment and received nutritional intervention. There was a trend in patients in the intervention group towards experiencing fewer postoperative pulmonary complications than those in the non-intervention group (9 vs 16%, respectively, P = 0.21) and fewer readmissions to hospital because of complications (5 vs 14% respectively, P = 0.12).

CONCLUSION

Chronic obstructive pulmonary disease-type pulmonary rehabilitation before and after lung cancer surgery is viable, and preliminary results suggest improvement in physical measures. A multicentre, randomized controlled trial is warranted to confirm clinical efficacy.

ISRCTN REGISTRATION NUMBER

ISRCTN00061628.

Item Type: Article
Subjects: QZ Pathology. Oncology
WG Cardiovascular system. Cardiology
Divisions: Planned IP Care > Oncology and Clinical Haematology
Planned IP Care > Thoracic Surgery
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Depositing User: Mrs Suganthi Vijayaganesh
Date Deposited: 09 Dec 2014 14:28
Last Modified: 09 Dec 2014 14:28
URI: http://www.repository.heartofengland.nhs.uk/id/eprint/763

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