Impact of preoperative respiratory training on early postoperative recovery in patients undergoing lung cancer surgery: a randomized controlled trial.

BACKGROUND

Non-small cell lung cancer (NSCLC) patients undergoing video-assisted thoracoscopic surgery (VATS) lobectomy often face postoperative complications and delayed recovery. While preoperative smoking cessation and respiratory training are known to improve outcomes, the potential benefits of integrating traditional Chinese medicine (TCM) interventions, such as LIUZIJUE, remain underexplored.

OBJECTIVE

This study aimed to evaluate the effects of preoperative respiratory training on perioperative outcomes in NSCLC patients undergoing VATS lobectomy, with a focus on peak expiratory flow (PEF), respiratory distress score (RPE), blood gas parameters, quality of recovery-15 (QOR-15), recovery room time, inflammatory markers (NLR, PLR), and postoperative complications.

METHODS

A single-center randomized controlled trial was conducted at Fujian Medical University Affiliated Second Hospital from April 2023 to June 2024. Smokers requiring a 2-week cessation period before surgery were randomized into three groups: Control Group (CG, standard care), Intervention Group 1 (IG1, standard care plus device-based respiratory training), and Intervention Group 2 (IG2, standard care plus respiratory training and LIUZIJUE practice).

RESULTS

The combined intervention group (IG2) demonstrated significant improvements in multiple postoperative outcomes, including PEF, QOR-15, RPE, and SpO, outperforming both IG1 and CG. Subgroup analyses revealed that patients over 60 years old experienced more pronounced improvements in PEF, RPE, SpO, and QOR-15 scores. Additionally, patients with comorbidities showed notable improvements in SpO and RPE, while those without comorbidities exhibited greater gains in SpO, PEF, and QOR-15.

CONCLUSION

Preoperative respiratory training combined with LIUZIJUE significantly enhances postoperative recovery in NSCLC patients, with particularly marked benefits for older patients and those without comorbidities. These findings highlight the clinical potential of this intervention for broader application in perioperative care.