This literature review identified randomized controlled trials examining preoperative rehabilitation for patients undergoing pulmonary resection. Interventions described across the included RCTs commonly consisted of aerobic exercise, resistance training, and respiratory training. When implemented for at least one week prior to surgery, these preoperative programs were associated with measurable improvements in exercise tolerance, reductions in postoperative pulmonary complications, and shorter length of hospital stay.
The review emphasizes that preoperative conditioning targets the decline in respiratory function and exercise capacity that typically follows pulmonary resection. By improving baseline physical and respiratory reserve, preoperative programs aim to reduce immediate postoperative morbidity.
Several trials included in the review examined very short preoperative interventions. The authors note that even a brief program lasting three days produced improvements in respiratory function and walking ability in some studies. Although the duration was short, these findings suggest that limited, focused respiratory and functional training may yield clinically relevant gains in the immediate perioperative period.
The review does not provide detailed protocols or standardized regimens from individual trials; it reports only that short-duration interventions were sometimes beneficial. Exact exercise prescriptions, intensity, or adherence metrics were not enumerated in the abstract.
Postoperative rehabilitation in the reviewed RCTs often included educational interventions designed to improve patient engagement with exercises and recovery activities after surgery. According to the review, educational approaches were linked to improved exercise compliance and in some trials to reduced postoperative complications.
However, the review highlights that effects of postoperative rehabilitation were inconsistent across studies. While some RCTs demonstrated benefits, others did not show clear or replicated effects, and no consistent impact on long-term clinical endpoints was observed.
A key, consistent finding in the review is that preoperative rehabilitation reduced postoperative pulmonary complications and shortened length of hospital stay in multiple RCTs. The protective effect against pulmonary complications aligns with the interventions’ focus on respiratory training and improving exercise capacity prior to surgery.
The magnitude and statistical details of these reductions are not reported in the abstract. The summary emphasizes direction and consistency across included trials rather than pooled quantitative effect sizes.
The review found no clear evidence from the included RCTs that perioperative rehabilitation—preoperative or postoperative—improves long-term outcomes such as hospital readmission rates or overall survival. The authors explicitly state that long-term prognosis effects remain limited in the available randomized evidence and that current trials have not demonstrated consistent benefit for these endpoints.
The authors searched the PubMed database and limited the review to randomized controlled trials published in English. From an initial yield of 103 articles, 14 RCTs met screening and inclusion criteria and were summarized for intervention details, timing of implementation, outcomes assessed, and observed effects.
Outcomes of interest specified by the review included exercise tolerance, postoperative complications, length of hospital stay, readmission rates, and survival.
The review highlights several limitations in the current RCT literature as summarized in the abstract. Trial heterogeneity in intervention type, duration, and timing contributed to inconsistent postoperative findings. Details on intervention protocols are not provided in the abstract, and pooled or meta-analytic synthesis is not reported.
Most importantly, evidence regarding long-term outcomes such as readmission and survival is limited, and the authors call for future studies to address these gaps. The optimal duration, intensity, and components of perioperative rehabilitation remain incompletely defined by the randomized evidence summarized.
Based on the randomized trials included, the review supports the clinical benefit of preoperative rehabilitation before pulmonary resection to preserve exercise tolerance, reduce postoperative pulmonary complications, and shorten hospital stay. Even short-term preoperative interventions may offer benefit.
Postoperative educational rehabilitation may improve adherence and reduce complications in some settings, but evidence is inconsistent.
The review recommends further randomized research that focuses on long-term outcomes, standardizes intervention components and timing, and evaluates sustained effects on readmission and survival. Detailed intervention protocols and measures of adherence and intensity would strengthen future evidence and help define best practices.
Note: The abstract and article metadata provided the basis for this summary. Specific trial protocols, quantitative effect sizes, and detailed statistical results were not reported in the abstract and therefore are not included here.