Research Group for Rehabilitation in Internal Disorders, Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, KU Leuven, Leuven, Belgium.
Clinical Department of Respiratory Diseases, UZ Leuven, BREATHE Department CHROMETA, KU Leuven, Leuven, Belgium.
Chron Respir Dis. 2021 Jan-Dec;18:1479973121994783. doi: 10.1177/1479973121994783.
The rehabilitation needs of individuals undergoing thoracic surgery are changing, especially as surgical management is increasingly being offered to patients who are at risk of developing functional limitations during and after hospital discharge. In the past rehabilitative management of these patients was frequently limited to specific respiratory physiotherapy interventions in the immediate postoperative setting with the aim to prevent postoperative pulmonary complications. In the past two decades, this focus has shifted toward pulmonary rehabilitation interventions that aim to improve functional status of individuals, both in the pre- and (longer-term) postoperative period. While there is increased interest in (p)rehabilitation interventions the majority of thoracic surgery patients are however currently on their own with respect to progression of their exercise and physical activity regimens after they have been discharged from hospital. There are also no formal guidelines supporting the referral of these patients to outpatient rehabilitation programs. The current evidence regarding rehabilitation interventions initiated before, during, and after the hospitalization period will be briefly reviewed with special focus on patients undergoing surgery for lung cancer treatment and patients undergoing lung transplantation. More research will be necessary in the coming years to modify or change clinical rehabilitation practice beyond the acute admission phase in patients undergoing thoracic surgery. Tele rehabilitation or web-based activity counseling programs might also be interesting emerging alternatives in the (long-term) postoperative rehabilitative treatment of these patients.
接受胸外科手术的个体的康复需求正在发生变化，特别是随着手术管理越来越多地提供给那些在住院期间和出院后有发生功能受限风险的患者。过去，这些患者的康复管理通常仅限于术后即刻特定的呼吸物理治疗干预，目的是预防术后肺部并发症。在过去的二十年中，这种重点已经转向旨在改善个体功能状态的肺康复干预措施，包括术前和（长期）术后。虽然人们对（预）康复干预的兴趣日益浓厚，但大多数胸外科患者在出院后，在推进其运动和体育活动方案方面，仍只能依靠自己。也没有正式的指南支持将这些患者转介到门诊康复计划。本文将简要回顾住院前、期间和后开展的康复干预的现有证据，重点关注接受肺癌治疗手术和肺移植的患者。未来几年，有必要开展更多的研究，以便在胸外科患者的急性入院阶段之外，对临床康复实践进行修改或改变。在这些患者的（长期）术后康复治疗中，远程康复或基于网络的活动咨询计划也可能是一种有趣的新兴替代方案。
