[Approaches to the pre-operative functional assessment of patients with lung cancer and preoperative rehabilitation].
Fiche publication
Date publication
décembre 2020
Journal
Revue des maladies respiratoires
Auteurs
Membres identifiés du Cancéropôle Est :
Pr OLLAND Anne
Tous les auteurs :
Charloux A, Enache I, Pistea C, Olland A
Lien Pubmed
Résumé
Surgery is the best treatment for early lung cancer but requires a preoperative functional evaluation to identify patients who may be at a high risk of complications or death. Guideline algorithms include a cardiological evaluation, a cardiopulmonary assessment to calculate the predicted residual lung function, and identify patients needing exercise testing to complete the evaluation. According to most expert opinion, exercise tests have a very high predictive value of complications. However, since the publication of these guidelines, minimally-invasive surgery, sublobar resections, prehabilitation and enhanced recovery after surgery (ERAS) programmes have been developed. Implementation of these techniques and programs is associated with a decrease in postoperative mortality and complications. In addition, the current guidelines and the cut-off values they identified are based on early series of patients, and are designed to select patients before major lung resection (lobectomy-pneumonectomy) performed by thoracotomy. Therefore, after a review of the current guidelines and a brief update on prehabilitation (smoking cessation, exercise training and nutritional aspects), we will discuss the need to redefine functional criteria to select patients who will benefit from lung surgery.
Mots clés
Bilan préopératoire, Cancer bronchique, Exploration fonctionnelle respiratoire, Lung cancer, Lung function tests, Lung resection, Preoperative assessment, Rehabilitation, Réhabilitation, Résection pulmonaire
Référence
Rev Mal Respir. 2020 12;37(10):800-810