Respiratory physiotherapy in the prevention of postoperative pulmonary complications following abdominal surgery
DOI:
https://doi.org/10.62827/fb.v27i6.1224Keywords:
Physical Therapy Modalities; Postoperative Complications; Surgical Procedures.Abstract
Introduction: Pulmonary complications are associated with worse postoperative outcomes in abdominal surgeries. Respiratory physiotherapy techniques have been incorporated into perioperative care to reduce the incidence of these events. Objective: To compare the effect of respiratory physiotherapy plus standard care versus standard care alone on the incidence of postoperative pulmonary complications in adults undergoing abdominal surgery. Methods: A systematic review with meta-analysis was conducted. After applying the eligibility criteria, four studies were included. Relative risk was used as the effect measure, along with a random-effects model and the I² index to assess heterogeneity. The level of certainty of the evidence and the risk of bias were analyzed using predefined criteria. Results: Heterogeneity was low (I²=0%; Cochran's Q test p=0.85). The overall quality of evidence was considered moderate, with studies rated as low to moderate risk of bias. The incidence of postoperative pulmonary complications was 11.1% in the intervention group and 30.95% in the control group, with a significant risk reduction in the group receiving respiratory physiotherapy (RR=0.36; 95% CI 0.18-0.72; p=0.004). A greater potential gain in inspiratory muscle strength was also observed in the intervention group. No relevant adverse events were reported. Conclusion: Structured perioperative respiratory physiotherapy protocols appear to significantly reduce the incidence of postoperative pulmonary complications after abdominal surgery. However, larger, methodologically standardized studies are needed to strengthen the available evidence.
References
Huang YT, Lin YJ, Hung CH, Cheng HC, Yang HL, Kuo YL, et al. The fully engaged inspiratory muscle training reduces postoperative pulmonary complications rate and increased respiratory muscle function in patients with upper abdominal surgery: a randomized controlled trial [Internet]. Ann Med. 2022 Aug 9 [cited 2026 May 8];54(1):2222–32. Available from: https://pubmed.ncbi.nlm.nih.gov/35942800/ . doi:10.1080/07853890.2022.2106511
Taha MM, Draz RS, Gamal MM, Ibrahim ZM. Adding autogenic drainage to chest physiotherapy after upper abdominal surgery: effect on blood gases and pulmonary complications prevention. Randomized controlled trial [Internet]. Sao Paulo Med J. 2021 Dec [cited 2026 May 8].139(6):556–63. Available from: https://www.scielo.br/j/spmj/a/bk3YLjqqZstsMyyGJ6snQ6h/?format=html&lang=en . doi:10.1590/1516-3180.2021.0048.0904221
Boden I, Sullivan K, Hackett C, Winzer B, Hwang R, Story D, et al. Intensive physical therapy after emergency laparotomy: Pilot phase of the Incidence of Complications following Emergency Abdominal surgery Get Exercising randomized controlled trial [Internet]. J Trauma Acute Care Surg. 2022 Jan 18 [cited 2026 May 8]. 92(6):1020–30. Available from: https://pubmed.ncbi.nlm.nih.gov/35609291/ . doi:10.1097/TA.0000000000003542
Haddaway NR, Page MJ, Pritchard CC, McGuinness LA. PRISMA2020: An R package and Shiny app for producing PRISMA 2020-compliant flow diagrams, with interactivity for optimised digital transparency and Open Synthesis [Internet]. Campbell Syst Rev. 2022 Mar 27 [cited 2026 May 8];18(2):e1230. https://doi.org/10.1002/cl2.1230. Available from: https://pubmed.ncbi.nlm.nih.gov/36911350/
Mizusawa H, Yuji Higashimoto, Shiraishi O, Shiraishi M, Ryuji Sugiya, Noguchi M, et al. Inspiratory Muscle Training Before Esophagectomy Increases Diaphragmatic Excursion: A Randomized Controlled Trial [Internet]. Ann Surg Oncol. 2024 Sep 16 [cited 2026 May 8];31(13):9352–61.Available from: https://pubmed.ncbi.nlm.nih.gov/39283579/ . doi:10.1245/s10434-024-16180-1
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Copyright (c) 2026 Carina Marques Freire, Fernando Andrade Donzeli, Gabriela Assis de Oliveira Bicalho, Márcia Christiane Oliveira Rodrigues, Maria Clara Batista Andrade (Autor)
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