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Subcostal Specimen Removal in Completely Portal Robotic Lobectomy
Published on: April 19, 2024
Postoperative Respiratory Exercises Reduce the Risk of Developing Pulmonary Complications in Patients Undergoing
Ana Rodriguez-Larrad1, Juan Manuel Vellosillo-Ortega2, Carlos Ruiz-Muneta2
1Departamento de Fisiología, Universidad del País Vasco, Leioa, Vizcaya, España.
Objective:
To evaluate the effects of an intensive postoperative physiotherapy program focused on respiratory exercises in patients undergoing lobectomy by open thoracotomy.
Design:
Quasi-experimental study.
Setting:
Tertiary referral academic hospital.
Participants:
208 patients undergoing lobectomy by open thoracotomy.
Interventions:
Control group patients (n=102) received standard medical/nursing care, and experimental group patients (n=106) added to the standard clinical pathway a daily physiotherapy program focused on respiratory exercises until discharge.
Outcomes:
Analyzed outcomes were the frequency of postoperative pulmonary complications (PPCs) more amenable to physiotherapy (pneumonia, atelectasis and respiratory insufficiency) and length of hospital stay (LOS).
Results:
Both groups were comparable regarding preoperative and surgical characteristics. Incidence of PPCs was 20.6% in control and 6.6% in experimental group (P=.003). Median (IQR) LOS in control group was 14 (7) days (Huber M estimator 14.21) and 12 (6) days (Huber M estimator 12.81) in experimental. Logistic regression model identified the evaluated physiotherapy program (P=.017; EXP [B] 95% CI 0.081-0.780) and % FEV1 (P=.042; EXP [B] 95% CI 0.941-0.999) as protective factors for the development of PPCs in patients undergoing lobectomy.
Conclusions:
Implementing a postoperative intensive physiotherapy program focused on respiratory exercises reduces the risk of PPCs and resultant LOS on patients undergoing lobectomy.
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