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Background  An evaluation of cardiopulmonary exercise testing ( CPET ) screening and pre‐operative pulmonary rehabilitation in reducing postoperative complications and improving fast‐track recovery in high‐risk patients who undergo resection for lung cancer.    Methods  Of 342 potential lung cancer cases, 142 high‐risk patients were finally divided into two groups: group  R  (n = 71) underwent an intensive pre‐operative pulmonary rehabilitation program ( PRP ), followed by lobectomy; group  S  (n = 71) underwent only lobectomy with conventional management. Postoperative complications, average days in hospital, postoperative days in hospital, and cost were analyzed.    Results  The 142 high‐risk patients were screened by smoking history and  CPET . Sixty‐eight patients had bronchial hyperresponsiveness ( BHR ) and 47 patients had peak expiratory flow <250 L/minute by  CPET . The rate of postoperative total complications in group  R  (16.90%) was significantly lower than in group  S  (83.31%) ( P  = 0.00), as was the rate of postoperative pulmonary complications  PPC : group  R  (12.81%)  versus   S  (13.55%) ( P  = 0.009); the  PPC  in the left lung (17.9%) was higher than in the right lung (2.3%) ( P  = 0.00). The average days in hospital in group  S  was significantly higher than in group  R  ( P  = 0.03). There was no difference between groups in average hospital cost ( P  = 0.304).    Conclusion  Pre‐operative screening using  CPET  is conducive to identifying high‐risk patients for lung resection. Pre‐operative pulmonary rehabilitation is helpful to reduce postoperative complications and improve fast‐track recovery.

thoracic cancer

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