Effect of pulmonary rehabilitation training on postoperative recovery in lung cancer patients undergoing thoracoscopic partial pulmonary resection: a meta-analysis

Objective: To systematically analyze the impact of pulmonary rehabilitation (PR) on postoperative recovery of lung cancer patients undergoing thoracoscopic partial pulmonary resection.

Methods: This study has been registered with PROSPERO (CRD42024574965). A comprehensive search was conducted in PubMed, The Cochrane Library, Embase, Web of Science and CINAHL for literature on the effects of PR on postoperative rehabilitation in lung cancer patients undergoing thoracoscopic partial pulmonary resection, up to May 2024. Studies meeting the inclusion and exclusion criteria were selected for the meta-analysis. Valid data were extracted, and the integrated analysis was performed using RevMan5.3 and Stata 12.0 software.

Results: A total of 10 relevant studies, involving 677 subjects, were included. Of these, 341 patients were in the experimental group, and 336 were in the control group. The meta-analysis showed that PR significantly improved the forced expiratory volume in the first second after surgery (FEV1) [SMD=1.73, 95% CI: (0.52-2.94)], peak expiratory flow (PEF) [SMD=0.45, 95% CI: (0.12-0.78)], forced vital capacity (FVC) [SMD=4.31, 95% CI: (1.98-6.63)], and 6 min walking distance (6MWD) [SMD=1.64, 95% CI: (0.64-2.65)]. PR also reduced the incidence of postoperative complications [OR=0.28, 95% CI: (0.18-0.43)] and shortened the duration of postoperative hospitalization [SMD=-0.56, 95% CI: (-0.88 - -0.24)] in lung cancer patients undergoing thoracoscopic partial pulmonary resection. There was no significant difference in anxiety [SMD=-0.34, 95% CI: (-1.27-0.60)] or depression [SMD=-0.15, 95% CI: (-0.48-0.18)] between the two groups.

Conclusion: PR improves lung function and exercise tolerance, reduces postoperative complications, and shortens postoperative hospital stays in lung cancer patients undergoing thoracoscopic partial pulmonary resection. However, its effect on reducing negative mood remains unclear. Due to the limitations in the number and quality of included studies, further high-quality studies are needed to validate these findings.