Department of Respiratory and Critical Care Medicine, Shanghai Chest Hospital, Medical School of Shanghai Jiao Tong University, Shanghai, China; Department of Respiratory and Critical Care Medicine, Regional Medical Center for National Institute of Respiratory Diseases, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China; Cancer Center, Zhejiang University, Hangzhou, China.
Department of Respiratory and Critical Care Medicine, Shanghai Chest Hospital, Medical School of Shanghai Jiao Tong University, Shanghai, China.
Ann Palliat Med. 2022 May;11(5):1605-1623. doi: 10.21037/apm-22-549.
Comorbidity of lung cancer and chronic obstructive pulmonary disease (COPD) is very common. Surgical operation is the initial treatment of lung cancer. But surgery operation will aggravate the symptoms of COPD, such as shortness of breath, chest tightness. On the other side, the COPD also increase the perioperative complications. Besides, the COPD may also influence the anti-cancer treatment and long-term survival of lung cancer patients. At present, there are guidelines for pulmonary rehabilitation (PR) of COPD or lung cancer respectively, but there is no reference expert consensus on the PR of patients with lung cancer who are comorbidity of COPD. Primary care has to satisfy the patient's complex needs holistically, and single-disease guidelines are unsuitable. In view of this, we organized experts from respiratory department, thoracic surgery department, oncology department, nursing department, etc., to write the expert consensus. We discussed the contents of the expert consensus through literature review, expert correspondence, expert meeting and discussion. This expert consensus contain five parts: introduction, respiratory assessment, timing of PR, PR strategies, perioperative PR management strategies in lung cancer patients with COPD. This expert consensus focuses on patients with COPD comorbid lung cancer and undergoing surgery operation, highlighting the concept of whole process management. For clinical medical staff, this expert consensus will promote the practice of PR in and out the hospital for this specific patient; for patients, this expert consensus is helpful to better understand PR and improve the enthusiasm of participating in PR in the whole process.
肺癌与慢性阻塞性肺疾病(COPD)合并存在非常常见。外科手术是肺癌的初始治疗方法。但手术会加重 COPD 的症状,如呼吸困难、胸闷。另一方面,COPD 也会增加围手术期并发症。此外,COPD 还可能影响肺癌患者的抗癌治疗和长期生存。目前,针对 COPD 或肺癌分别有肺康复(PR)指南,但针对合并 COPD 的肺癌患者的 PR 尚无参考专家共识。初级保健必须全面满足患者的复杂需求,而单一疾病指南并不适用。有鉴于此,我们组织了呼吸科、胸外科、肿瘤科、护理科等专家,撰写专家共识。我们通过文献复习、专家函询、专家会议讨论等方式对专家共识的内容进行了讨论。本专家共识共包含五部分内容:引言、呼吸评估、PR 时机、PR 策略、COPD 合并肺癌患者围手术期 PR 管理策略。本专家共识重点关注合并 COPD 并接受手术治疗的肺癌患者,突出全程管理的理念。对于临床医务人员来说,本专家共识将促进他们在院内和院外开展针对这一特定患者的 PR 实践;对于患者而言,本专家共识有助于他们更好地了解 PR,并提高全程参与 PR 的积极性。