RESTORATION OF THE RESPIRATORY RESERVE OF THE LUNGS IN PATIENTS BEFORE SURGERY

Chizhikov Andrey Valeryevich, Abdullin Zamir Salikhovich, Yakovleva Olesya Gennadyevna, Sharipov Ural Firdausovich, Mukhtarov Ilmir Vinerovich, Abdullin Ilmir Salikhovich

Purpose of the study: The main purpose of this study was to investigate the effect of short-term respiratory reserve therapy in patients with impaired respiratory function who are about to undergo surgical treatment for lung cancer. Materials and Methods: The study included 18 patients diagnosed with moderate COPD in remission from 50 to 72 years old (17 men and 1 woman aged 60 years). The diagnosis was morphologically verified as non-small cell lung cancer (NSCLC). Patients were selected to be functionally inoperable, despite a high risk of postoperative complications due to the development of respiratory failure, but suitable for surgical lung resection, based on the stage of the disease. Patients were offered a 2-week course of preoperative rehabilitation: walking more than 1 km per day, breathing exercises and inhalation therapy. Spirometry data: FEV1 (forced expiratory volume in 1 second), FVC (functional vital capacity), six-minute walking distance, maximum inspiratory and expiratory volumes. Preoperative and postoperative spirometry was assessed. Results: After preoperative pulmonary rehabilitation, there was a marked improvement in spirometry, air conduction (p<0.001), maximum inspiratory volume (12 cm H2O, p<0.001), 6-minute walk distance (53 m, p<0.001), forced vital lung capacity (p<0.001), predicted forced expiratory volume in 1 second (%) (p=0.001), forced expiratory volume in one second = 150 ml, p = 0.001, Δ maximum forced expiratory volume in one second: 650 ml ) and predicted maximum oxygen uptake (p<0.001). At the end of the rehabilitation course, 61% of patients (n = 11) evaluated by surgeons could be operated on. Thus, it is advisable to send patients to rehabilitation before surgery before making a decision about the inoperability of the patient.

Keywords:lung cancer, COPD, respiratory function, preoperative rehabilitation course of treatment