BACKGROUND: To investigate the influence of preoperative physical training combining aerobic and breathing exercises on surgical lung cancer patients with impaired lung function. METHODS: A total of 68 patients with predicted postoperative FEV1% < 60% were equally and randomly assigned into one-week physical training combining aerobic and breathing exercises (intervened group: IG) or routine preoperative preparation (control group: CG). Then, 6-min walking distance (6-MWD), in-hospital length of stay (LOS), and other clinical variables were included and recorded. RESULTS: An increase of 22.6 +/- 27.0 m of 6-MWD was observed in IG, compared to 2.7 +/- 27.6 m in CG (between-group difference 19.9 m, 95% CI 6.7 to 33.2, p = 0.004), but no difference was found in lung function. The emotional function of EORTC-QLQ-30 was significantly improved in IG after the training regimen, compared to CG. Meanwhile, the intervened patients (IG) had significantly lower postoperative pulmonary complication (PPC) rate (11.8%, 4/34 versus 35.3%, 12/34, p = 0.022), shorter postoperative LOS (median 5.0 (interquartile 4.0 to 7.0) versus 8.0 (7.0 to 10.0) days, p < 0.001) and lower costs, including total cost (48,588.7 (44,999.1 to 52,693.3) versus 52,445.3 (49,002.9 to 61,994.0), p = 0.016), material cost (23,350.8 (18,300.6 to 26,421.9) versus 25,730.0 (21,328.7 to 29,250.2), p = 0.048) and drug cost (7,230.0 (6,661.9 to 8,347.4) versus 11,388.6 (7,963.0 to 16,314.3), p < 0.001). CONCLUSIONS: The preoperative physical training combining aerobic and breathing exercises can improve exercise capacity, decrease the occurrence of PPCs, and shorten LOS with lower in-hospital cost; it thus shows potential to be an effective preparation strategy for surgical lung cancer patients with limited lung function.

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