Due to its debilitating character pneumonectomy this is last-resort procedure. Preoperative results of the 6-min walking test (6MWT) help to identify high risk of postoperative complications and increased mortality in patients undergoing lobectomy for lung cancer. The aim of the study was to validate the value of 500 m in 6MWT as an indicator, which differentiates risk of complications in patients undergoing pneumonectomy. 125 patients who underwent pneumonectomy at Thoracic Surgery Department between 2009 and 2018. On the day preceding the surgery, patients underwent 6MWT. The patients were in median age of 63 years. The cut-off value of 500 m identified patients with increased 90-day mortality [17.9% vs. 3.5%, odds ratio (OR) 6.271, 95% confidence interval (CI) 1.528–25.739], first-year mortality (30.7% vs. 11.6%, OR 3.378, 95% CI 1.310–8.709), and overall survival (p = 0.02). Patients who covered a distance ≤ 500 m had an increased risk of atrial fibrillation (35.9% vs. 16.3%, OR 2.880, 95% CI 1.207–6.870) and cardiac complications (38.4% vs. 19.8%, OR 2.537, 95% CI 1.100–5.849). Patients unable to reach 500 m in 6MWT are in a high risk of postoperative death after pneumonectomy, what may be a result of increased frequency of postoperative cardiac complications. Poor result of 6MWT is a predictor of worse overall survival.

The 6-min walk test (6MWT) is a simple method of identifying patients with a high risk of postoperative complications. In this study, we internally validated the previously obtained threshold value of 500 m in the 6MWT as differentiating populations with a high and a low risk of postoperative complications after a lobectomy. Between November 2011 and November 2016, 624 patients who underwent a lobectomy and performed the 6MWT preoperatively entered this study. We compared the complication rates of two groups of patients—those who walked more than and those who walked less than 500 m. The patients who did not reach the distance of 500 m in the 6MWT were older (70 vs. 63 years p < 0.001), had worse pulmonary function tests (FEV1% 84 vs. 88 p = 0.041) and had a higher Charlson Comorbidity Index (p < 0.001). The patients who had a worse result in the 6MWT had a higher complication rate (52% vs. 42% p = 0.019; OR: 1.501 95% CI: 1.066–2.114) and a longer median postoperative hospital stay (7 vs. 6 days p = 0.010). In a multivariate analysis, the result of the 6MWT and pack-years proved to independently influence the risk of postoperative complications. This internal validation study confirms that 500 m is a result of the 6MWT which differentiates patients with a higher risk of postoperative complications and a prolonged hospital stay after a lobectomy.

The purpose of the paper is a functional assessment of post-mastectomy patients who underwent latissimus dorsi breast reconstruction (LDBR), and of healthy women, through an analysis of selected muscle function parameters, including motor control assessment. Twenty participants were included in the study (ten LDBR-procedure individuals and ten healthy controls). The research consisted of a DASH (The Disabilities of the Arm, Shoulder and Hand) questionnaire assessment, shoulder area static assessment, shoulder mobility assessment, latissimus dorsi flexibility assessment and shoulder motor control assessment. LDBR-procedure individuals—when compared to healthy controls—exhibited a decrease in physical aspects of quality of life, shoulder area postural alterations, limitations in shoulder mobility and decrease in shoulder motor control. LDBR procedure may have an influence on limiting shoulder active mobility, as well as on decrease of shoulder motor and postural control. Standard functional assessment diversified on motor control assessment of post-mastectomy patients qualified for the LDBR procedure seems to be necessary.

Lung parenchyma resection is the treatment of choice for early-stage lung cancer. The surgery involves the loss of respiratory surface and consequently leads to reduction in exercise capacity. Proper rehabilitation is essential for restoring the function and good performance of the respiratory system. Rehabilitation should be an integral part of surgical treatment. It should be implemented early and maintained until full restoration of function and fitness. The paper discusses the physiotherapeutic procedure in patients after lung parenchyma resection. Under current guidelines, the recommended physiotherapeutic approach has been described as a multi-stage process. A preoperative exercise program can prepare the patient better for surgery and reduce the risk of some postoperative complications. Since there is a tendency to shorten the hospital stay, guidelines in preparation for surgery have been developed in the form of leaflets given to patients. In specifically described perioperative treatment we can see the physiotherapeutic procedures that the patient, after lung parenchyma resection, may undergo. Physiotherapy protocol was documented using a proposed patient’s card that described the basic treatment and included additional space for comments, in case of complications etc. Post-hospital rehabilitation, described in accordance with current guidelines, complements the treatment after surgery as a whole. To achieve the goals of rehabilitation a team of closely cooperating specialists must emerge. It should include physicians, physiotherapists, nurses, psychologists and occupational therapists. Family support plays a significant role as well. Proper education for patients and informing them about the purposefulness of the treatment are very significant factors. Further analysis allowed the creation of an algorithm for physiotherapeutic care in patients without complications after lung cancer surgery. Lung parenchyma resection is the treatment of choice for early-stage lung cancer. The surgery involves the loss of respiratory surface and consequently leads to reduction in exercise capacity. Proper rehabilitation is essential for restoring the function and good performance of the respiratory system. Rehabilitation should be an integral part of surgical treatment. It should be implemented early and maintained until full restoration of function and fitness. The paper discusses the physiotherapeutic procedure in patients after lung parenchyma resection. Under current guidelines, the recommended physiotherapeutic approach has been described as a multi-stage process. A preoperative exercise program can prepare the patient better for surgery and reduce the risk of some postoperative complications. Since there is a tendency to shorten the hospital stay, guidelines in preparation for surgery have been developed in the form of leaflets given to patients. In specifically described perioperative treatment we can see the physiotherapeutic procedures that the patient, after lung parenchyma resection, may undergo. Physiotherapy protocol was documented using a proposed patient’s card that described the basic treatment and included additional space for comments, in case of complications etc. Post-hospital rehabilitation, described in accordance with current guidelines, complements the treatment after surgery as a whole. To achieve the goals of rehabilitation a team of closely cooperating specialists must emerge. It should include physicians, physiotherapists, nurses, psychologists and occupational therapists. Family support plays a significant role as well. Proper education for patients and informing them about the purposefulness of the treatment are very significant factors. Further analysis allowed the creation of an algorithm for physiotherapeutic care in patients without complications after lung cancer surgery.

Aim: Pathological TNM (pTNM) remains the most significant prognostic factor of non-small cell lung cancer (NSCLC). Age, gender, pulmonary function tests, the extent of surgical resection and presence of concomitant diseases are commonly used to complete the profile of the patient with early stage of NSCLC. The aim of the study was to assess the influence of the result of 6-minute walk test (6MWT) on the prognosis of patients with surgically treated NSCLC.

Background: The prediction of postoperative functional status in non-small cell lung cancer patients based on preoperative assessment of physical and respiratory capacity is inadequate based on recent RCTs. Material and methods: Prospectively collected spirometry data and the six-minute walk test results of 57 patients treated with lobectomy for non-small cell lung cancer were analyzed. The tests were performed before surgery, and 30 and 90 days after lobectomy. All patients underwent a respiratory functional and physical capacity assessment. Results: All 57 patients underwent lobectomy. Before surgery, mean FEV1 was 2.4 ± 0.7 L, corresponding to %FEV1 of 88.3 ± 17.3%. The mean absolute and expected 6MWT distance was 548 ± 74.6 m and 108.9 ± 14.5%, respectively. At the first postoperative evaluation 30 days after surgery, FEV1 and %FEV1 decreased significantly by an average of 0.5 ± 0.3 L and 15.1 ± 10.7%, while 6MWT and expected 6MWT decreased minimally by an average of 1.0 m and 0.8%, respectively. Three months after lobectomy, FEV1 and %FEV1, compared with the initial assessment, decreased by an average of 0.3 ± 0.3 l and 7.8 ± 10.0%, while 6MWT and its expected score increased to 564.6 ± 84.6 m and 112.8 ± 15.8%, respectively. Conclusions: After lobectomy, FEV1 decreased slightly and less than expected, while 6MWT increased proportionally compared to the preoperative evaluation.