Feasibility of postoperative home-based pulmonary function training for lung cancer patients: a real-world study.

Abstract

Background: Pulmonary surgery can significantly impact patients' respiratory function and reduce their quality of life. Previous studies have shown that perioperative breathing exercises (BE) can facilitate the recovery of lung function and improve patients' quality of life after surgery. However, due to the lack of supervision and awareness, patients often struggle to adhere to the prescribed exercise regimen. This study statistics and analyzes the effect of postoperative respiratory function training on postoperative recovery of patients undergoing pneumonectomy in a realistic environment, in order to provide a basis for optimizing postoperative rehabilitation strategies.

Methods: Patients undergoing surgical treatment for pulmonary nodules received standardized education upon admission, including guidance on performing breathing exercises. Preoperative pulmonary function tests (PFT) and arterial oxygen saturation measurements were conducted, and patients were instructed to return for follow-up pulmonary function and arterial oxygen saturation assessments at 1 month, 3 months, and 6 months post-surgery. In addition, patients were asked to complete online questionnaires at these time points. Oxygen saturation levels were also re-assessed before discharge, and patients were encouraged to complete a discharge questionnaire. Weekly phone calls were made to remind patients to continue their breathing exercises. The study analyzed 12 potential factors that might affect the outcomes, including preoperative nebulization use, surgical method, and patient age. The primary outcome measures were the effects of postoperative breathing exercises on FEV1, FVC, DLCO, and SPO2 at 1 month (T1), 3 months (T2), and 6 months (T3) post-surgery. Secondary outcomes included LCQ cough assessment, FACT-L quality of life assessment, evaluations of pain and appetite, SAS anxiety level, SDS depression level, AIS sleep quality, and the modified MRAC assessment of dyspnea symptoms.

Results: The study initially enrolled 296 patients (T0), including 233 patients who underwent sublobar resection (SRP) and 63 patients who underwent lobectomy (LBP). Between T0 and T1, 203 patients remained in the SRP group and 47 in the LBP group. Between T0 and T2, 36 patients remained in the SRP group and 9 in the LBP group. By T3, the SRP group had 14 patients, and the LBP group had 5 patients remaining. Due to incomplete data, SPO2 measurements were excluded from the analysis. Additionally, the SRP group at T3 and the LBP group at T2 and T3 were not included in the analysis.In the SRP group, at T1, the BE group showed significantly better recovery in FEV1 and FVC compared to the control group. By T2, the BE group had a significantly improved sleep quality compared to the control group (P < 0.05). In the LBP group, at T1, the BE group demonstrated a significant advantage in alleviating anxiety symptoms compared to the control group (P < 0.05). No significant differences were observed in other outcomes.