Article

We report two cases of perioperative rehabilitation for abdominal cancer
patients aged 75 years and older with severe chronic obstructive pulmonary disease (COPD). Description: Case 1 was a 75-year-old man with COPD and
52-year history of smoking 30 cigarettes per day.
The patient was diagnosed with
gastric cancer and scheduled for laparoscopic total gastrectomy. Preoperative
forced expiratory volume in 1 second (FEV1) was 0.64 L. He could walk with
intermittent rest. Case 2 was an 81-year-old woman with COPD, bronchial asthma
and 40-year history of smoking 20 cigarettes per day. She was diagnosed with
transverse colon cancer and scheduled for laparoscopic-assisted partial
transverse colectomy. Preoperative FEV1 was 0.70 L. She could walk indoors with
T-cane. RESULTS: All staff started performing tasks simultaneously a week before
surgery. Both patients were extubated soon after surgery; they could sit and take
deep breaths soon after admission to intensive care unit. They could perform
stepping movements early next morning, return to the general ward in the
afternoon and started gait training. Because both patients could independently
perform activities of daily living, they were discharged on postoperative day 13.
CONCLUSION: Comprehensive perioperative rehabilitation appears to be effective in
high-risk patients with severe COPD who need surgery for abdominal cancer.

Langue : ANGLAIS