Is Incentive Spirometry Beneficial for Patients with Lung Cancer Receiving Video-assisted Thoracic Surgery?

Overview

Journal BMC Pulm Med

Publisher Biomed Central

Specialty Pulmonary Medicine

Date 2019 Jul 10

PMID 31286923

Citations 6

Authors

Chin-Jung Liu

Wen-Chen Tsai

Chia-Chen Chu

Chih-Hsin Muo

Wei-Sheng Chung

Affiliations

Soon will be listed here.

Abstract

Background: The effectiveness of Incentive spirometry (IS) in patients undergoing video-assisted thoracic surgery (VATS) remains lacking. We conducted a population-based study to investigate the effectiveness of IS on patients with lung cancers following VATS.

Methods: We identified patients newly diagnosed with lung cancer who underwent surgical resection by VATS or thoracotomy from the years 2000 to 2008 in the Longitudinal Health Insurance Database. Exposure variable was the use of IS during admission for surgical resection by VATS or thoracotomy. Primary outcomes included hospitalization cost, incidence of pneumonia, and length of hospital stay. Secondary outcomes included the frequency of emergency department (ED) visits and hospitalizations at 3-month, 6-month, and 12-month follow-ups after thoracic surgery.

Results: We analyzed 7549 patients with lung cancer undergoing surgical resection by VATS and thoracotomy. The proportion of patients who were subjected to IS was significantly higher in those who underwent thoracotomy than in those who underwent VATS (68.4% vs. 53.1%, P < 0.0001). After we controlled for potential covariates, the IS group significantly reduced hospitalization costs (- 524.5 USD, 95% confidence interval [CI] = - 982.6 USD - -66.4 USD) and the risk of pneumonia (odds ratio = 0.55, 95% CI = 0.32-0.95) compared to the non-IS group following VATS. No difference in ED visit frequency and hospitalization frequency at 3-month, 6-month, and 1-year follow-up was noted between the IS and the non-IS groups following VATS.

Conclusions: The use of IS in patients with lung cancers undergoing VATS may reduce hospitalization cost and the risk of pneumonia.

Citing Articles

The Role of Incentive Spirometry in Enhanced Recovery After Lung Cancer Resection: A Propensity Score-Matched Study.

Casiraghi M, Orlandi R, Bertolaccini L, Mazzella A, Girelli L, Diotti C J Clin Med. 2025; 14(1.

PMID: 39797184 PMC: 11720981. DOI: 10.3390/jcm14010100.

Effects of oscillatory positive expiratory pressure therapy in patients undergoing thoracic or upper abdominal surgery: A systematic review and meta-analysis.

You J, Jiang B, Dai N, Lu B, Zhao C, Zheng Z Heliyon. 2024; 10(18):e37798.

PMID: 39315191 PMC: 11417579. DOI: 10.1016/j.heliyon.2024.e37798.

A case report of cardiopulmonary exercise testing and incentive spirometry-guided breathing pattern alteration for a severely tachypnoeic kyphoscoliotic patient undergoing major thoracic surgery for suspected lung malignancy.

Wong A, Lam C SAGE Open Med Case Rep. 2024; 12:2050313X241275384.

PMID: 39290560 PMC: 11406589. DOI: 10.1177/2050313X241275384.

Effects of pre-transplant chest physical therapy on spirometric values and respiratory muscle strength in patients waiting for allogeneic hematopoietic stem cell transplantation: a randomized controlled trial.

Waked I, Ibrahim Z, Alkhamees N, Rashad A Arch Med Sci. 2024; 20(1):104-112.

PMID: 38414465 PMC: 10895947. DOI: 10.5114/aoms/150780.

The effect of incentive spirometry in perioperative patients with lung cancer-a systematic review and meta-analysis.

Liang Y, Chen S, Song J, Deng T, Yang J, Long Y BMC Pulm Med. 2024; 24(1):88.

PMID: 38360672 PMC: 10870616. DOI: 10.1186/s12890-024-02878-1.

References

. AARC (American Association for Respiratory Care) clinical practice guideline. Incentive spirometry. Respir Care. 1991; 36(12):1402-5. View

Nakata M, Saeki H, Yokoyama N, Kurita A, Takiyama W, Takashima S . Pulmonary function after lobectomy: video-assisted thoracic surgery versus thoracotomy. Ann Thorac Surg. 2000; 70(3):938-41. DOI: 10.1016/s0003-4975(00)01513-7. View

Kaseda S, Aoki T, Hangai N, Shimizu K . Better pulmonary function and prognosis with video-assisted thoracic surgery than with thoracotomy. Ann Thorac Surg. 2000; 70(5):1644-6. DOI: 10.1016/s0003-4975(00)01909-3. View

Li W, Lee T, Lam S, Ng C, Sihoe A, Wan I . Quality of life following lung cancer resection: video-assisted thoracic surgery vs thoracotomy. Chest. 2002; 122(2):584-9. DOI: 10.1378/chest.122.2.584. View

Kacmaz Basoglu O, Atasever A, Bacakoglu F . The efficacy of incentive spirometry in patients with COPD. Respirology. 2005; 10(3):349-53. DOI: 10.1111/j.1440-1843.2005.00716.x. View

Lawrence V, Cornell J, Smetana G . Strategies to reduce postoperative pulmonary complications after noncardiothoracic surgery: systematic review for the American College of Physicians. Ann Intern Med. 2006; 144(8):596-608. DOI: 10.7326/0003-4819-144-8-200604180-00011. View

Agostini P, Calvert R, Subramanian H, Naidu B . Is incentive spirometry effective following thoracic surgery?. Interact Cardiovasc Thorac Surg. 2007; 7(2):297-300. DOI: 10.1510/icvts.2007.171025. View

Cattaneo S, Park B, Wilton A, Seshan V, Bains M, Downey R . Use of video-assisted thoracic surgery for lobectomy in the elderly results in fewer complications. Ann Thorac Surg. 2007; 85(1):231-5. DOI: 10.1016/j.athoracsur.2007.07.080. View

Whitson B, Groth S, Duval S, Swanson S, Maddaus M . Surgery for early-stage non-small cell lung cancer: a systematic review of the video-assisted thoracoscopic surgery versus thoracotomy approaches to lobectomy. Ann Thorac Surg. 2008; 86(6):2008-16. DOI: 10.1016/j.athoracsur.2008.07.009. View

10.

Casali G, Walker W . Video-assisted thoracic surgery lobectomy: can we afford it?. Eur J Cardiothorac Surg. 2009; 35(3):423-8. DOI: 10.1016/j.ejcts.2008.11.008. View

11.

Flores R, Park B, Dycoco J, Aronova A, Hirth Y, Rizk N . Lobectomy by video-assisted thoracic surgery (VATS) versus thoracotomy for lung cancer. J Thorac Cardiovasc Surg. 2009; 138(1):11-8. DOI: 10.1016/j.jtcvs.2009.03.030. View

12.

Guimaraes M, El Dib R, Smith A, Matos D . Incentive spirometry for prevention of postoperative pulmonary complications in upper abdominal surgery. Cochrane Database Syst Rev. 2009; (3):CD006058. DOI: 10.1002/14651858.CD006058.pub2. View

13.

Yang X, Wang S, Qu J . Video-assisted thoracic surgery (VATS) compares favorably with thoracotomy for the treatment of lung cancer: a five-year outcome comparison. World J Surg. 2009; 33(9):1857-61. DOI: 10.1007/s00268-009-0137-9. View

14.

Cho S, Do Y, Lee E . Comparison of costs for video-assisted thoracic surgery lobectomy and open lobectomy for non-small cell lung cancer. Surg Endosc. 2010; 25(4):1054-61. DOI: 10.1007/s00464-010-1315-4. View

15.

Whitson B, Groth S, Andrade R, Maddaus M, Habermann E, DCunha J . Survival after lobectomy versus segmentectomy for stage I non-small cell lung cancer: a population-based analysis. Ann Thorac Surg. 2011; 92(6):1943-50. DOI: 10.1016/j.athoracsur.2011.05.091. View

16.

Restrepo R, Wettstein R, Wittnebel L, Tracy M . Incentive spirometry: 2011. Respir Care. 2011; 56(10):1600-4. DOI: 10.4187/respcare.01471. View

17.

Freitas E, Soares B, Cardoso J, Atallah A . Incentive spirometry for preventing pulmonary complications after coronary artery bypass graft. Cochrane Database Syst Rev. 2012; (9):CD004466. PMC: 8094624. DOI: 10.1002/14651858.CD004466.pub3. View

18.

Hulzebos E, Smit Y, Helders P, van Meeteren N . Preoperative physical therapy for elective cardiac surgery patients. Cochrane Database Syst Rev. 2012; 11:CD010118. PMC: 8101691. DOI: 10.1002/14651858.CD010118.pub2. View

19.

Silva Y, Li S, Rickard M . Does the addition of deep breathing exercises to physiotherapy-directed early mobilisation alter patient outcomes following high-risk open upper abdominal surgery? Cluster randomised controlled trial. Physiotherapy. 2012; 99(3):187-93. DOI: 10.1016/j.physio.2012.09.006. View

20.

Haines K, Skinner E, Berney S . Association of postoperative pulmonary complications with delayed mobilisation following major abdominal surgery: an observational cohort study. Physiotherapy. 2012; 99(2):119-25. DOI: 10.1016/j.physio.2012.05.013. View