Perioperative physiotherapy for thoracic surgery: Evidence regarding pulmonary function, mobility, and respiratory complications

Abstract

Introduction: Thoracic surgeries can cause significant changes in ventilatory mechanics, reduced lung volumes, pain, limited mobility, and an increased risk of postoperative respiratory complications. In this context, physical therapy plays a relevant role in preserving lung function, encouraging early mobilization, and preventing complications such as atelectasis and pneumonia. Objective: To summarize the importance of physical therapy in the postoperative period following thoracic surgery, emphasizing its effects on pulmonary function, early mobilization, functional recovery, and the reduction of respiratory complications. Methods: This is an integrative literature review of a qualitative and descriptive nature. Searches were conducted in the PubMed/MEDLINE, SciELO, and Virtual Health Library (VHL) databases using descriptors related to thoracic surgery, physical therapy, postoperative care, lung function, early mobilization, and respiratory complications, combined using the Boolean operators AND and OR. Studies published in Portuguese and English that were available in full text and addressed physical therapy interventions or outcomes related to respiratory and functional recovery during the perioperative period were included. Following the identification, screening, and eligibility stages, four studies comprised the final sample. Results: The analyzed studies included prospective observational designs, a randomized clinical trial, and a clinical commentary article. The main outcomes evaluated were postoperative pulmonary complications, pneumonia, atelectasis, lung function, pulmonary diffusion capacity, pain, mobility, length of hospital stay, intensive care unit admission, and postoperative recovery. The findings indicated that respiratory risk factors, functional limitation, and pain can negatively influence recovery after surgical procedures. Physical therapy, through respiratory and early mobilization strategies, has the potential to contribute to the prevention of complications and to functional recovery. However, the heterogeneity of the studies, the diversity of the surgical procedures evaluated, and the limited number of investigations specifically focused on thoracic surgery constrain the definition of standardized protocols. Conclusion: Physiotherapy plays an important role in the perioperative care of patients undergoing thoracic surgery, particularly in preserving pulmonary function and encouraging early mobilization. However, more robust and specific clinical studies are needed to establish more consistent physiotherapy protocols tailored to this population.