Effect of Preoperative Respiratory Training on Perioperative Outcomes in Thoracic Surgery: A Systematic Review and Meta-Analysis.

IF 0.9 4区医学 Q3 SURGERY

Annali italiani di chirurgia Pub Date : 2025-09-10 DOI:10.62713/aic.4272

Yufang Zhu, Yinguo Du, Ming Zhang

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引用次数: 0

Abstract

Aim: Postoperative pulmonary complications (PPCs) commonly ensue after thoracic surgery and can impair patients' recovery. This study aimed to evaluate the effectiveness of preoperative respiratory training (PRT) in various perioperative outcomes in patients undergoing thoracic surgery, including pulmonary function, exercise capacity, incidence of postoperative complications, and length of hospital stay.

Methods: Randomized controlled trials (RCTs) comparing PRT with routine care, that were published in the period of 1 January 2000 to 30 June 2025, were identified through PubMed, Embase, Web of Science, and Cochrane Library. Pooled analyses were performed using RevMan 5.4.1 to calculate odds ratio (OR) or mean difference (MD) with 95% CI.

Results: Nine studies were included in the meta-analysis. The results revealed that PRT significantly reduces PPCs (OR = 0.31, 95% CI: 0.21 to 0.46) and improved the change in six-minute walking distance (6MWD) (MD = 20.50, 95% CI: 11.72 to 29.28). No significant effects were observed on absolute 6MWD, forced expiratory volume in one second (FEV₁), peak expiratory flow, or length of hospital stay. Sensitivity analysis confirmed result stability, and no substantial publication bias was found.

Conclusions: PRT reduces PPCs and improves postoperative functional recovery in patients undergoing thoracic surgery. Its impact on spirometry-based pulmonary function and length of hospital stay remains uncertain. Further large-scale trials are needed to investigate the effect of integrating perioperative care into routine healthcare, especially for high-risk patients.

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术前呼吸训练对胸外科围手术期预后的影响：系统回顾和荟萃分析。

目的：术后肺部并发症（PPCs）是胸外科手术后常见的并发症，可影响患者的康复。本研究旨在评估术前呼吸训练（PRT）对胸外科手术患者围手术期预后的影响，包括肺功能、运动能力、术后并发症发生率和住院时间。方法：通过PubMed、Embase、Web of Science和Cochrane Library检索2000年1月1日至2025年6月30日发表的PRT与常规护理的随机对照试验（rct）。采用RevMan 5.4.1进行合并分析，计算95% CI的优势比（OR）或平均差（MD）。结果：9项研究被纳入meta分析。结果显示，PRT显著降低PPCs (OR = 0.31, 95% CI: 0.21 ~ 0.46)，改善6分钟步行距离（6MWD）的变化（MD = 20.50, 95% CI: 11.72 ~ 29.28）。在绝对6MWD、一秒钟用力呼气量（FEV1）、呼气峰流量或住院时间方面未观察到显著影响。敏感性分析证实了结果的稳定性，未发现明显的发表偏倚。结论：PRT可降低PPCs，改善胸外科患者术后功能恢复。它对基于肺活量测定的肺功能和住院时间的影响尚不确定。需要进一步的大规模试验来调查围手术期护理纳入常规医疗保健的效果，特别是对高危患者。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Annali italiani di chirurgia 医学-外科

CiteScore

0.90

自引率

12.50%

发文量

116

审稿时长

>12 weeks

期刊介绍： Annali Italiani di Chirurgia is a bimonthly journal and covers all aspects of surgery:elective, emergency and experimental surgery, as well as problems involving technology, teaching, organization and forensic medicine. The articles are published in Italian or English, though English is preferred because it facilitates the international diffusion of the journal (v.Guidelines for Authors and Norme per gli Autori). The articles published are divided into three main sections:editorials, original articles, and case reports and innovations.