Short-Term Preoperative High-Intensity Interval Training in Patients Awaiting Lung Cancer Surgery: A Randomized Controlled Trial |
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| Affiliation: | 1. Department of Anesthesiology, Pharmacology and Intensive Care, University Hospital of Geneva, Geneva, Switzerland;2. Faculty of Medicine, University of Geneva, Geneva, Switzerland;3. Division of Thoracic Surgery, University Hospital of Geneva, Geneva, Switzerland;4. Division of Internal Medicine, Hopital La Tour in Geneva, Geneva, Switzerland;5. Institute of Sports Science and Department of Physiology at the Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland;6. Division of Pneumology, Hospital du Valais in Sion, Sion, Switzerland |
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| Abstract: | ![]()
IntroductionImpairment in aerobic fitness is a potential modifiable risk factor for postoperative complications. In this randomized controlled trial, we hypothesized that a high-intensity interval training (HIIT) program enhances cardiorespiratory fitness before lung cancer surgery and therefore reduces the risk of postoperative complications.MethodsPatients with operable lung cancer were randomly assigned to usual care (UC) (n = 77) or preoperative rehabilitation based on HIIT (Rehab) (n = 74). Maximal cardiopulmonary exercise testing and the 6-minute walk test were performed twice before surgery. The primary outcome measure was a composite of death and in-hospital postoperative complications.ResultsThe groups were well balanced in terms of patient characteristics. During the preoperative waiting period (median 25 days), the peak oxygen consumption and the 6-minute walking distance increased (median +15%, interquartile range, 25th to 75 percentile [IQR25%–75%, %] = +9% to +22%, p = 0.003 and +15%, IQR25%–75% = +8% to +28%, p < 0.001, respectively) in the Rehab group, whereas peak oxygen consumption declined in the UC group (median –8%, IQR25%–75% = –16% to 0%], p = 0.005). The primary end point did not differ significantly between the two groups: at least one postoperative complication developed in 27 of the 74 patients (35.5%) in the Rehab group and 39 of 77 patients (50.6%) in the UC group (p = 0.080). Notably, the incidence of pulmonary complications was lower in the Rehab compared with in the UC group (23% versus 44%, p = 0.018), owing to a significant reduction in atelectasis (12.2% versus 36.4%, p < 0.001), and this decrease was accompanied by a shorter length of stay in the postanesthesia care unit (median –7 hours, IQR25%–75% = –4 to –10).ConclusionsIn this randomized controlled trial, preoperative HIIT resulted in significant improvement in aerobic performances but failed to reduce early complications after lung cancer resection. |
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| Keywords: | Rehabilitation Postoperative complications Aerobic capacity Exercise training |
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