[Risk stratification before thoracic surgery, perioperative pulmonary rehabilitation]

Area of Science:

• Thoracic Surgery
• Pulmonary Medicine
• Oncology

Background:

• Operability in lung cancer extends beyond surgical techniques to include functional aspects.
• Preoperative risk stratification and evaluation of postoperative complications are crucial for patient management.

Purpose of the Study:

• To review international literature and institutional experiences on risk stratification in thoracic surgery.
• To evaluate the role of functional parameters and pulmonary rehabilitation in lung cancer surgery.

Main Methods:

• Literature review focused on risk stratification in thoracic surgery, considering lung function, mechanics, exercise physiology.
• Evaluation of pulmonary rehabilitation's effectiveness on cardiopulmonary function, muscle strength, exercise capacity, and quality of life.
• Inclusion of laboratory parameters, comorbidities (COPD, heart failure, obesity, cachexia), and smoking cessation in the analysis.

Main Results:

• Elevated blood sugar, impaired kidney function, and low albumin levels are associated with increased surgical risk.
• COPD, sleep apnea, heart failure, obesity, and cachexia negatively impact surgical outcomes.
• Smoking cessation, controlled breathing techniques, chest wall mobilization, and exercise training show positive effects on reducing complications and improving function.

Conclusions:

• Risk stratification for lung cancer surgery is supported by laboratory findings, lung function tests, oxygen uptake, and comorbidity assessment.
• Pulmonary rehabilitation offers a viable strategy to enhance patient functionality and improve quality of life post-surgery.