Prehabilitation and physiotherapy in lung cancer resection: A narrative review
DOI:
https://doi.org/10.62827/fb.v27i9.1325Keywords:
Lung Neoplasms; Exercise Therapy; Rehabilitation; Preoperative Exercise; Pneumonectomy.Abstract
Introduction: Lung resection for cancer may impair exercise tolerance, and preventing complications does not ensure complete functional recovery. Objective: To analyze evidence on prehabilitation, respiratory physiotherapy, and postoperative exercise, distinguishing their effects on pulmonary complications, exercise capacity, and functional recovery. Methods: A narrative review with searches in September 2026 in PubMed and Scientific Electronic Library Online. Studies published from 2021 to 2026 were prioritized while retaining relevant earlier trials. Synthesis considered the phase of care, comparator, and outcomes. Results: Preoperative exercise reduced pulmonary complications in a synthesis of trials. In a recent multicenter trial of high-risk patients, multimodal prehabilitation reduced the composite of pulmonary complications, with the reduction mainly influenced by prolonged air leak. For preoperative mobility, the guideline analyzed recommended combined programs instead of breathing exercises alone. One trial comparing prehabilitation and postoperative multimodal rehabilitation found no difference in recovery of functional capacity. Routine addition of incentive spirometry to physiotherapy showed no consistent benefit. After resection, exercise improved exercise capacity, whereas effects on self-reported function, fatigue, and quality of life were less uniform. Conclusion: Integrating preoperative preparation, individualized respiratory care, and progressive reconditioning after discharge is clinically coherent, but superiority of the complete pathway has not been demonstrated. Assessment needs to track respiratory and functional outcomes separately. Optimal dosage, patient selection, and maintenance of benefits remain uncertain.
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Copyright (c) 2026 Rafael Viana dos Santos Coutinho, Bárbara Zatti Lima de Souza, Lucimar Hintz de Freitas Júnior, Carolina Pirani Vieira Parisi, Isabella Pereira Martins (Autor)
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