Fast-Track Rehabilitation

Feasibility at Home of a Rehabilitation Program Before Thoracic Surgery, for Pulmonary Parenchyma Exeresis

This study is a prospective observational study which aim to evaluate the feasibility of a total and systematic home respiratory rehabilitation training program in patients who will undergo thoracic surgery, and otherwise tend to define failure reasons.

The aim of this clinical trial is to identify the determining factors which impact a preoperative home respiratory rehabilitation training program success. This success is determined by complete achievement of the program (100%) by the patient.

This rehabilitation program is composed by 4 items:

• Adapted physical activity : 3 averaging cyclo ergometer or physical activity seances per week (25%)
• Physiotherapy sessions : 8 seances with a physical therapist (25%)
• Smokers : Set up of a program to help give up smoking if active smoker (25%)
• Dietetics : If unintentionally weight loss (>5% total weight in 1 month or >10% in 6 months) or BMI<21 , nutritional assessment is conducted and dietetic program is initiated(25%)

Secondary objectives are :

• Assessment of postoperative event onset (30 days) (atelectasis, fibro-aspiration, time spent in resuscitation unit, intubation, revision surgery).
• Link assessment of 100% program success and at least one complication onset.
• Cost assessment of preoperative rehabilitation program
• Evaluation of mean hospitalisation duration post surgery (30 days)
• Average cost assessment of hospitalisation stay per patient.

This study will include 50 patients over 18 years old, addressed to the home heath care provider AGIR à Dom, for rehabilitation before pulmonary parenchyma exeresis.

Patients must perform at least 2 items of rehabilitation program previously described.

This program is an initiative of a pulmonologist or a thoracic surgeon, who include the patient when the date of surgery is scheduled.

Inclusion Criteria:

• Patients who need a respiratory rehabilitation before thoracic surgery for lung resection.
• Patients addressed to the home heath care provider "AGIR à Dom",
• Patients must perform at least 2 items of rehabilitation program (Adapted physical activity, Diet, Physiologist, Smoking)

Exclusion Criteria:

• Patients who participate to another interventional research that may impact this study.
• Patients unable to get involved to the training program, depending to the investigator's appreciation.