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Early Recovery After "Wedge Resection" Surgery to Remove Lung Mestastasis Secondary to Bone Cancer.

Completed
Conditions
Metastasis Lung
Bone Neoplasm
Registration Number
NCT05310539
Lead Sponsor
Istituto Ortopedico Rizzoli
Brief Summary

After "wedge resection" surgery, the physiotherapy programs proposed in the literature are heterogeneous and there are few data on the outcomes of such treatments in an oncological population for bone cancer.

The aim of the study is to describe the early rehabilitation process after wedge resection surgery secondary to bone tumor pulmonary mestasasis, highlightining the possible functional recovery in the short and medium term after surgery and indentifying the possible prognostic factors.

Detailed Description

In Italy, the incidence of primary bone tumors is around 0.8-1 case per 100,000 inhabitants, therefore an estimated 500 new cases of primary malignant bone tumors are estimated each year, affecting more frequently in children and young people. The presence of pulmonary metastasis occurs in 30% of the population with bone cancer and is the most common site of metastasis. Where possible, the elective treatment of lung metastases is ablative surgery and the wedge resection technique is also commonly used in the event of repeated metastasis over time. Pulmonary wedge resection surgery does not follow the anatomical limits of the lung but it is customized according to the metastatic area to be removed, thus differentiating itself from lobectomies and other thoracotomy surgical techniques.

The trend of vital capacity (CV) and forced expiratory volume in 1s (FEV1), after wedge resection surgery, significantly decrease at 3 months compared to the preoperative evaluation, while at 12 months the CV returns to values close to the preoperative ones and FEV1 remains significantly lower. Rehabilitation treatment is part of the multidisciplinary approach for this type of patient in order to prevent post-surgical respiratory complications (PPC) and shoulder girdle dysfunctions, in the treatment of pain and in the recovery of respiratory volumes. Several authors, describing the physiotherapy treatment techniques, include breathing exercises (Active Cycle Breathing Techniques), early mobilization exercises for the lower limbs and the use of volume incentives. The physiotherapy treatment programs proposed in the literature are heterogeneous and there are no data on the feasibility of such treatments in an oncological population for bone cancer.

Patients are enrolled consecutively in a ward of an italian hospital specialized in bone tumor surgery.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
75
Inclusion Criteria
  • over 12 years of age
  • ablative thoracic surgery for metastases localized to the lung and / or chest wall for primary bone cancer
  • must be able to perform the "one minute sit-to-stand" test in the preoperative physiotherapy evaluation
Exclusion Criteria
  • ablative thoracic surgery for a diagnosis DIFFERENT FROM that of lung metastases

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
1 minute sit to stand (Sixth day after surgery)Sixth day after surgery

The test requires the person to stand up from a chair, without the help of the arms, fully extending their knees, and sit down the greatest number of times in the time of one minute.

Secondary Outcome Measures
NameTimeMethod
mBorg Scoreonce a day, before and after 1 minute sit to stand test, up to 7 day

dyspnea (shortness of breath, sometimes described as "air hunger") it will be assess using Borg Modified Scale, from 0 to 10, when 0 means "none" (better outcome) and 10 means "maximum" (worse outcome).

vital capacity (ml)every day after surgery up to 7 day, twice a day

the vital capacity will be assess with incentive spirometer named "respirex"

1 minute sit to stand (daily)every day after surgery up to 7 day; at 3, 6 and 12 months after surgery.

The test requires the person to stand up from a chair, without the help of the arms, fully extending their knees, and sit down the greatest number of times in the time of one minute.

pain intensityevery day after surgery up to 7 day, twice a day

numeric rating scale (from 0 (no pain) to 10 (worst possible pain))

heart rate (bpm)once a day, before and after 1 minute sit to stand test, up to 7 day

beats per minute; it will be assess with pulse oximeter

peripheral oxygen saturation (SpO2 %)once a day, before and after 1 minute sit to stand test, up to 7 day

it will be assess with pulse oximeter

Trial Locations

Locations (1)

Istituto Ortopedico Rizzoli

🇮🇹

Bologna, Emilia Romagna, Italy

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