Efectos de un programa de rehabilitación pulmonar perioperatoria en pacientes sometidos a cirugía torácica: estudio de corte observacional retrospectivo

Abstract

Introduction: Thoracic surgery has a significant impact on the functional capacity and quality of life of patients. Prehabilitation and pulmonary rehabilitation programs based on structured physical exercise improve recovery and reduce complications. In Chile, the evidence for their implementation is limited. Objective: To evaluate the effect of pulmonary prehabilitation and rehabilitation programs in patients undergoing thoracic surgery after one year of operation at the San Juan de Dios Hospital at Santiago, Chile. Methods: Observational retrospective cohort study in patients who underwent sur- gery between January and December 2025. Pre- and post-interventions were compared in each group independently assessing: quality of life (SF-36), dyspnea (mMRC), frailty (SPPB), functional capacity (ISWT, STST1M), muscle strength (handgrip, STST5R), and recovery heart rate (HRR). Paired and comparative statistical tests (p < 0.05) (95%CI) were applied. Results: A total of 33 patients were included, age 61.5 ± 13.9 years-old; 72.7% had lung cancer, divided into prehabilitation (n = 13) and postoperative rehabilitation (n = 20). Both groups showed improvements in physical fitness and quality of life (p < 0.001). In pre-habilitation, dyspnea decreased 2 points in mMRC, ISWT increased 26.3% and STST1M 32,5%. In rehabilitation, ISWT improved 58.8%, STST1M 68.1% and prehensile strenght grip 29,3% (p < 0.001). More than 90% achieved significant clinical improvement. Conclusion: The implementation of a structured program of pulmonary prehabilitation and rehabilitation in thoracic surgery is associated with clinically and statistically significant improvements in functional capacity and quality of life, suggesting its integration into perioperative management in public hospitals, after additional evidence coming from prospective research under controlled protocols and adequate sample size.