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Effect of radical resection of lung cancer combined with breathing training on lung cancer patients in thoracic surgery: a meta-analysis

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Title: Effect of radical resection of lung cancer combined with breathing training on lung cancer patients in thoracic surgery: a meta-analysis
Authors: Biao Lu, Xiaobing Li, Hao Jiang
Source: BMC Pulmonary Medicine, Vol 25, Iss 1, Pp 1-12 (2025)
Publisher Information: BMC, 2025.
Publication Year: 2025
Collection: LCC:Diseases of the respiratory system
Subject Terms: Radical resection of LC, Breathing training, RMS, Lung function, Postoperative pulmonary complications, MA, Diseases of the respiratory system, RC705-779
Description: Abstract Background Its objective was to use meta-analysis (MA) to methodically assess the impact of perioperative breathing exercises on the postoperative rehabilitation of patients with lung cancer (LC) having radical resection. Methods PubMed, and other databases were searched for randomized controlled trials on radical resection of LC combined with perioperative respiratory training from January 1995 to January 2024. After quality assessment, MA was performed using Review Manager 5.3 software. Results A total of 14 studies involving 880 patients were included, of which 434 patients received perioperative breathing training (Intervention group, IG). The differences between the two groups in terms of MIP (MD = -13.31, 95% CI: [-24.43, -2.19]; Z = 2.35, P = 0.02), FVC (MD = -0.23, 95% CI = [-0.36, -0.11]; Z = 3.69, P = 0.0002), 6-minute walk test (6MWT) values (MD = 36.42, 95% CI: [4.37, 68.48]; Z = 2.23, P = 0.03), incidence of pneumonia (OR = 0.38, 95% CI = 0.20–0.72; Z = 2.95, P = 0.003), and complication rates (OR = 0.66, 95% CI = 0.46–0.94; Z = 2.29, P = 0.02) were statistically significant. However, there were no significant differences between the two groups in MEP (MD = -6.10, 95% CI: [-12.10, -0.11]; Z = 2.00, P = 0.05), FEV1 (MD = -0.25, 95% CI = [-0.58, 0.08]; Z = 1.47, P = 0.14), FEV1/FVC (MD = -3.78, 95% CI = [-7.65, 0.09]; Z = 1.91, P = 0.06), PEF (MD = -15.02, 95% CI = [-45.88, 15.83]; Z = 0.95, P = 0.34), atelectasis (OR = 0.52, 95% CI = 0.24–1.12; Z = 1.68, P = 0.09), pneumothorax (OR = 1.20, 95% CI = 0.63–2.29; Z = 0.57, P = 0.57), and mechanical ventilation incidence (OR = 0.99, 95% CI = 0.34–2.91; Z = 0.01, P = 0.99). Conclusion This MA demonstrates that perioperative respiratory training significantly improves MIP, FVC, and 6MWT in patients undergoing radical LC surgery, while effectively reducing the incidence of postoperative pneumonia and overall complications. However, its impact on MEP, certain pulmonary function parameters (FEV1, FEV1/FVC, PEF), and specific complications (atelectasis, pneumothorax, mechanical ventilation requirement) did not reach statistical significance. The findings support the inclusion of respiratory training in perioperative rehabilitation programs for LC patients to optimize postoperative recovery outcomes.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 1471-2466
Relation: https://doaj.org/toc/1471-2466
DOI: 10.1186/s12890-025-03819-2
Access URL: https://doaj.org/article/8d94670f6c6e49238dedb62fffe8c25c
Accession Number: edsdoj.8d94670f6c6e49238dedb62fffe8c25c
Database: Directory of Open Access Journals
Description
Abstract:Abstract Background Its objective was to use meta-analysis (MA) to methodically assess the impact of perioperative breathing exercises on the postoperative rehabilitation of patients with lung cancer (LC) having radical resection. Methods PubMed, and other databases were searched for randomized controlled trials on radical resection of LC combined with perioperative respiratory training from January 1995 to January 2024. After quality assessment, MA was performed using Review Manager 5.3 software. Results A total of 14 studies involving 880 patients were included, of which 434 patients received perioperative breathing training (Intervention group, IG). The differences between the two groups in terms of MIP (MD = -13.31, 95% CI: [-24.43, -2.19]; Z = 2.35, P = 0.02), FVC (MD = -0.23, 95% CI = [-0.36, -0.11]; Z = 3.69, P = 0.0002), 6-minute walk test (6MWT) values (MD = 36.42, 95% CI: [4.37, 68.48]; Z = 2.23, P = 0.03), incidence of pneumonia (OR = 0.38, 95% CI = 0.20–0.72; Z = 2.95, P = 0.003), and complication rates (OR = 0.66, 95% CI = 0.46–0.94; Z = 2.29, P = 0.02) were statistically significant. However, there were no significant differences between the two groups in MEP (MD = -6.10, 95% CI: [-12.10, -0.11]; Z = 2.00, P = 0.05), FEV1 (MD = -0.25, 95% CI = [-0.58, 0.08]; Z = 1.47, P = 0.14), FEV1/FVC (MD = -3.78, 95% CI = [-7.65, 0.09]; Z = 1.91, P = 0.06), PEF (MD = -15.02, 95% CI = [-45.88, 15.83]; Z = 0.95, P = 0.34), atelectasis (OR = 0.52, 95% CI = 0.24–1.12; Z = 1.68, P = 0.09), pneumothorax (OR = 1.20, 95% CI = 0.63–2.29; Z = 0.57, P = 0.57), and mechanical ventilation incidence (OR = 0.99, 95% CI = 0.34–2.91; Z = 0.01, P = 0.99). Conclusion This MA demonstrates that perioperative respiratory training significantly improves MIP, FVC, and 6MWT in patients undergoing radical LC surgery, while effectively reducing the incidence of postoperative pneumonia and overall complications. However, its impact on MEP, certain pulmonary function parameters (FEV1, FEV1/FVC, PEF), and specific complications (atelectasis, pneumothorax, mechanical ventilation requirement) did not reach statistical significance. The findings support the inclusion of respiratory training in perioperative rehabilitation programs for LC patients to optimize postoperative recovery outcomes.
ISSN:14712466
DOI:10.1186/s12890-025-03819-2