Chest physiotherapy revisited: evaluation of its influence on the pulmonary morbidity after pulmonary resection

Novoa, Nuria; Ballesteros, Esther; Jiménez, Marcelo F.; Aranda, José Luis; Varela, Gonzalo
July 2011
European Journal of Cardio-Thoracic Surgery;Jul2011, Vol. 40 Issue 1, p130
Academic Journal
Abstract: Objective: The study aimed to evaluate if perioperative chest physiotherapy modifies the risk of pulmonary morbidity after lobectomy for lung cancer. Methods: We have reviewed a prospectively recorded database of 784 lung cancer patients treated by scheduled lobectomy (361 operated after implementing a new physiotherapy program). No other changes were introduced in the patients’ perioperative management during the study period. A propensity matching score was generated for all eligible patients and two logistic models were constructed and adjusted. The first one (model A) included age of the patient, forced expiratory volume in 1s (percent) (FEV1%) and predicted postoperative forced expiratory volume in 1s (percent) (ppoFEV1%); for the second model (model B); chest physiotherapy was added to the previous ones. Using each model, patients’ individual probability of postoperative complication was calculated and maintained in the database as a new variable (risk A and risk B). Individual risks calculated by both models were plotted on a time series and presented in two different graphs. Results: Rates of pulmonary morbidity were 15.5% before the intensive physiotherapy program and 4.7% for patients included in the implemented program (p =0.000). The propensity score identified 359 pairs of patients. Model A included age (p =0.012), FEV1% (p =0.000), and ppoFEV1% (p =0.031) as prognostic variables. Model B included age (p =0.012), FEV1% (p =0.000), and physiotherapy (p =0.000). On graphic representation, a great decrease of the estimated risk could be seen after the onset of the physiotherapy program. Conclusions: Implementing a program of perioperative intensive chest physiotherapy reduced the overall pulmonary morbidity after lobectomy for lung cancer.


Related Articles

  • Limited resection and two-staged lobectomy for non-small cell lung cancer with ground-glass opacity. Ohtaka, Kazuto; Hida, Yasuhiro; Kaga, Kichizo; Kato, Tatsuya; Muto, Jun; Nakada-Kubota, Reiko; Hirano, Satoshi; Matsui, Yoshiro // Journal of Cardiothoracic Surgery;2013, Vol. 8 Issue 1, p1 

    Background: Lung tumors showing ground-glass opacities on high-resolution computed tomography indicate the presence of inflammation, atypical adenomatous hyperplasia, or localized bronchioloalveolar carcinoma. We adopted a two-staged video-assisted thoracoscopic lobectomy strategy involving...

  • Comparison of short-term effect of thoracoscopic segmentectomy and thoracoscopic lobectomy for the solitary pulmonary nodule and early-stage lung cancer. Mingming Ren; Qingjun Meng; Wenyan Zhou; Fanyi Kong; Bo Yang; Jun Yuan; Dongwen Wu; Jing Zhang; Qiaqia Li; Yunshou Lin; Viswanathan, Vidya Bhavani; Xiang Song // OncoTargets & Therapy;2014, Vol. 7, p1343 

    Purpose: To compare the short-term effect of anatomic video-assisted thoracoscopic surgery (VATS) segmentectomy and VATS lobectomy. Patients and methods: From January 2011 to December 2012, 21 patients underwent VATS segmentectomy and 61 underwent VATS lobectomy. Intraoperative blood loss,...

  • Predictive value of B-type natriuretic peptide for postoperative atrial fibrillation following pulmonary resection for lung cancer Nojiri, Takashi; Maeda, Hajime; Takeuchi, Yukiyasu; Funakoshi, Yasunobu; Kimura, Toru; Maekura, Ryoji; Yamamoto, Kazuhiro; Okumura, Meinoshin // European Journal of Cardio-Thoracic Surgery;Apr2010, Vol. 37 Issue 4, p787 

    Abstract: Objective: To evaluate the usefulness of atrial natriuretic peptide (ANP) and brain B-type natriuretic peptide (BNP) for predicting postoperative atrial fibrillation (AF), we determined the changes in perioperative ANP and BNP levels in patients undergoing pulmonary resection for lung...

  • Video-assisted thoracic bronchial sleeve lobectomy with bronchoplasty for treatment of lung cancer confined to a single lung lobe: a case series of Chinese patients. Daping Yu; Yi Han; Shijie Zhou; Xiaoyun Song; Yunsong Li; Ning Xiao; Zhidong Liu // Journal of Cardiothoracic Surgery;2014, Vol. 9 Issue 1, p1 

    Background The outcomes of video-assisted thoracic bronchial sleeve lobectomy (VABSL), a minimally invasive video-assisted thoracoscopic (VATS) lobectomy, are mostly unknown in Chinese patients. Objectives To investigate operative and postoperative outcomes of VABSL in a cases series of Chinese...

  • Thoracoscopy in the management of congenital lung diseases in infancy. Boubnova, Julia; Peycelon, Matthieu; Garbi, Olivier; David, Marion; Bonnard, Arnaud; Lagausie, Pascal De // Surgical Endoscopy;Feb2011, Vol. 25 Issue 2, p593 

    Background: This study aimed to compare the results of thoracoscopic surgery for congenital lung diseases between infants younger than 6 months and those older than 6 months at the time of surgery in terms of operation duration, surgical complications, chest tube duration, and hospital stay....

  • INDICATIONS ET/OU GESTES CHIRURGICAUX INHABITUELS DANS LE CANCER DU POUMON. Pavy, G. // Jurnalul de Chirurgie;2012, Vol. 8 Issue 1, p103 

    In lung cancer, surgical procedure is usually indicated for patients under 75 years old with a normal respiratory and cardiac function. Actually, the standard procedure is lobectomy, associated with an extensive lymphadenectomy. However, due to the people aging, the lung cancer incidence was...

  • Is lobectomy really more effective than sublobar resection in the surgical treatment of second primary lung cancer?†. Zuin, Andrea; Andriolo, Luigi Gaetano; Marulli, Giuseppe; Schiavon, Marco; Nicotra, Samuele; Calabrese, Francesca; Romanello, Paola; Rea, Federico // European Journal of Cardio-Thoracic Surgery;Aug2013, Vol. 44 Issue 2, pe120 

    OBJECTIVES Sublobar resection for early-stage lung cancer is still a controversial issue. We sought to compare sublobar resection (segmentectomy or wedge resection) with lobectomy in the treatment of patients with a second primary lung cancer. METHODS From January 1995 to December 2010, 121...

  • Experience with the autologous pulmonary vein for pulmonary arterioplasty. Puma, Francesco; Capozzi, Rosanna; Daddi, Niccolò; Ragusa, Mark; Cagini, Lucio; Quintili, Alessandro; Vannucci, Jacopo // European Journal of Cardio-Thoracic Surgery;Sep2011, Vol. 40 Issue 3, pe107 

    Abstract: Objective: Lobectomy with pulmonary artery resection and reconstruction is seldom performed in order to avoid pneumonectomy in selected cases. The aim of this study is to determine how safe and effective the graft reconstruction of the pulmonary artery is, using autologous tissue taken...

  • Predictors and Outcomes of Limited Resection for Early-Stage Non–Small Cell Lung Cancer. Billmeier, Sarah E.; Ayanian, John Z.; Zaslavsky, Alan M.; Nerenz, David R.; Jaklitsch, Michael T.; Rogers, Selwyn O. // JNCI: Journal of the National Cancer Institute;Nov2011, Vol. 103 Issue 21, p1621 

    Background Lobectomy is considered the standard treatment for early-stage non–small cell lung cancer (NSCLC); however, more limited resections are commonly performed. We examined patient and surgeon factors associated with limited resection and compared postoperative and long-term...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics