| Titre : | Video-assisted thoracoscopic lobectomy : which patients require postoperative physiotherapy? (2020) |
| Auteurs : | P. Agostini ; Sebastian Thomas Lugg ; Kerry Adams ; T. Smith ; Maninder Singh Kalkat ; Pala Babu Rajesh ; Richard S. Steyn ; B. Naidu ; Alison Rushton ; Ehab S. Bishay |
| Type de document : | Article |
| Dans : | Physiotherapy (Vol. 106, n° 1, Mars 2020) |
| Article en page(s) : | p. 87-93 |
| Note générale : | https://doi.org/10.1016/j.physio.2019.01.001 |
| Langues: | Anglais |
| Descripteurs : |
HE Vinci Atélectasie pulmonaire ; Chirurgie thoracique vidéoassistée ; Facteurs de risque ; Médecine physique et de réadaptation ; Pneumonie ; Réadaptation ; Techniques de physiothérapie |
| Résumé : |
Objectives
Following major thoracic surgery physiotherapy is recommended to improve reduced lung volume, aid secretion clearance, and improve mobility, however, in many centres physiotherapy provision is variable following minimally invasive video-assisted thoracoscopic surgery (VATS). The objective of this study was to observe frequency of problems potentially amenable to physiotherapy following VATS lobectomy, and to identify associated baseline factors of patients in whom physiotherapy may be beneficial. Methods A prospective observational study was performed including all consecutive cancer patients undergoing VATS lobectomy in a regional centre over 4 years (2012–2016). Standard postoperative care included early mobilisation by nursing staff from postoperative day one (POD1). Physiotherapy assessment of all patients on POD1 determined presence of issues potentially amenable to physiotherapy intervention, and treatment was commenced. Outcome measures included postoperative pulmonary complication (PPC) development, hospital and high dependency unit (HDU) length of stay (LOS). Results Of 285 patients, 209 (73%) received physiotherapy to assist/improve reduced mobility, of these 23 (8%) also received sputum clearance therapies and 65 (23%) specific therapy for lung volume loss. The remaining 76 (27%) patients had significantly lower hospital/HDU LOS (P Conclusion Following VATS lobectomy a large proportion of patients demonstrated issues potentially amenable to physiotherapy. The authors recommend that patients receive routine physiotherapy assessment following this type of surgery to ensure that all issues are identified early. Screening of COPD, BMI, preoperative mobility and age will allow early identification of patients who may benefit most from postoperative physiotherapy and preoperative optimisation, however, these factors cannot predict the need for physiotherapy. |
| Disponible en ligne : | Oui |
| En ligne : | https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/article/pii/S0031940619300069#! |
Bibliothèques HE Vinci
