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Impact of a 3-day preoperative inspiratory muscle training program on postoperative pulmonary complications in patients with prior abdominal radiotherapy undergoing major abdominal surgery: A randomized controlled trial
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K. Chen   , W. Wang , Y. Mu , J. Gan |
| Department of General Surgery, The Second Hospital & Clinical Medical School, Lanzhou University, Lanzhou 730030, China , 278593236@qq.com |
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Abstract: (17 Views) |
Background: Postoperative pulmonary complications (PPCs) are a major concern after abdominal surgery, particularly in patients with prior abdominal radiotherapy for gastrointestinal malignancies such as gastric, colorectal, and pancreatic cancers. The effect of very short-term preoperative inspiratory muscle training (IMT) in this population remains unclear. Materials and Methods: This single-center, single-masked randomized controlled trial included 100 patients who had completed abdominal radiotherapy (three-dimensional conformal radiotherapy or intensity-modulated radiotherapy; total dose 45–50.4 Gy) prior to undergoing major abdominal surgery. Participants were randomly assigned to IMT at 15%, 20%, or 30% of maximal inspiratory pressure (MIP), or to a control group performing balloon-blowing exercises. Training was performed three times daily for three consecutive days before surgery. All patients received standardized postoperative physiotherapy. The primary outcome was the incidence of PPCs during hospitalization. Secondary outcomes included length of hospital stay (LOS), hospitalization costs, pulmonary function indices, arterial blood gas parameters, and inflammatory markers. Results: The overall PPC incidence was 5%, with no significant differences between groups. The IMT 20% group demonstrated a significantly shorter LOS and lower hospitalization costs compared with control. Improvements in pulmonary function and oxygenation were observed in IMT groups, most consistently at 20% intensity. Conclusion: A three-day preoperative IMT program did not significantly reduce PPC incidence in previously irradiated patients, likely due to the low event rate. However, moderate-intensity IMT (20% MIP) may enhance perioperative recovery and reduce healthcare utilization. |
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| Keywords: Abdominal surgery, postoperative pulmonary complications, inspiratory muscle training, respiratory function, length of hospital stay. |
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Subject:
Radiation Biology
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