The Role of Incentive Respiratory Techniques in Enhanced Recovery After Lung Cancer Resection: A Propensity...

Area of Science:

• Thoracic Surgery
• Pulmonary Medicine
• Critical Care

Background:

• Postoperative physiotherapy is crucial in Enhanced Recovery After Surgery (ERAS) protocols for lung resection patients.
• Clear guidelines on incentive spirometry (IS) use post-lung resection are lacking.
• This study evaluates IS benefits alongside early ambulation in lung cancer surgery recovery.

Purpose of the Study:

• To assess if incentive spirometry provides additional benefits over early ambulation alone after lung resection for primary lung cancer.
• To compare postoperative pulmonary complication rates between patients receiving early ambulation with and without IS.
• To evaluate secondary outcomes including hospital stay duration and chest drain removal time.

Main Methods:

• Retrospective case-control study at the European Institute of Oncology (June 2020 - June 2022).
• Two cohorts: early ambulation alone (control) vs. early ambulation with IS (intervention).
• Propensity score matching (age, sex, BMI) for analysis; primary endpoint: postoperative pulmonary complications.

Main Results:

• 304 patients included; 52 per group after propensity-score matching.
• No significant differences in pulmonary complications (oxygen need, fever, atelectasis, etc.) between groups.
• Trends towards shorter hospital stay and faster chest drain removal in the IS group, but not statistically significant.

Conclusions:

• Incentive spirometry did not demonstrate significant added benefit over early ambulation alone for postoperative recovery after lung resection for primary lung cancer.
• Current findings suggest IS may not be essential in this specific patient population.
• Prospective, randomized trials are recommended to validate these results and explore potential benefits in specific subgroups.