Preoperative exercise-based prehabilitation reduces postoperative pulmonary complications and hospital stay after lung cancer surgeryExercise Before Surgery May Reduce Lung Cancer Complications

Frontiers in Medicine Published August 12, 2026 DOI ↗ Editorial oversight: Dr. Amelia Tan, PhD · Internal Medicine & Chronic Disease

AI-generated summary of the cited source, checked by automated accuracy review. How we work

Key Takeaway

Consider preoperative exercise-based prehabilitation to reduce pulmonary complications and shorten hospital stays after surgery.

This systematic review and meta-analysis evaluated the impact of preoperative exercise-based prehabilitation on patients undergoing surgery for lung cancer. The analysis included 29 randomized controlled trials involving 2,900 eligible surgical participants. The primary finding was a significant reduction in overall postoperative pulmonary complications (PPCs) with an RR of 0.42 (95% CI 0.33 to 0.53). Specific complications also showed reduced risks: pneumonia or pulmonary infection (RR = 0.52, 95% CI 0.36 to 0.75), atelectasis (RR = 0.36, 95% CI 0.25 to 0.51), and respiratory failure (RR = 0.37, 95% CI 0.17 to 0.78). Additionally, the intervention was associated with a shorter postoperative hospital stay of MD = -2.22 days (95% CI -2.52 to -1.92).

The authors note that the certainty of evidence for these clinical outcomes ranges from moderate to very low according to the GRADE approach. Furthermore, results regarding preoperative 6-minute walk distance were reported only narratively due to substantial heterogeneity among the studies.

Clinically, preoperative exercise-based prehabilitation may be a viable strategy to reduce complications and shorten hospital stays following lung cancer surgery. However, practitioners should note the variable certainty of evidence and the inconsistent data regarding functional improvements like 6-minute walk distance.

How this fits prior evidence

This meta-analysis extends previous findings on non-pharmacologic therapies for lung cancer patients by addressing a gap in perioperative care. While prior coverage noted that pulmonary rehabilitation may work best to improve cough in lung cancer, this study specifically addresses the reduction of postoperative complications and hospital stay duration through exercise-based prehabilitation.

A large review of 29 clinical trials involving 2,900 adults showed that exercise-based prehabilitation before surgery can help patients with lung cancer. The study looked at how these programs affected common issues like pneumonia, respiratory failure, and collapsed lung tissue (atelectasis) after the operation.

The results suggest that patients who participated in these exercise programs had a lower risk of several pulmonary complications compared to those receiving standard care. Additionally, these patients stayed in the hospital for about 2 days less on average following their surgery.

While the findings are promising, it is important to note that the quality of evidence varies across different outcomes. Some results regarding physical fitness tests were inconsistent. Because this study shows a link rather than a guarantee, patients should talk to their doctors to see if these specific exercise programs are right for their individual health needs.

What this means for you:

Preoperative exercise may reduce lung complications and shorten hospital stays after lung cancer surgery.

Common questions

Can exercise before surgery help my recovery from lung cancer?

The study suggests that exercise-based prehabilitation can reduce the risk of several complications, such as pneumonia and respiratory failure. It also showed a reduction in hospital stay by about 2.22 days for patients undergoing lung cancer surgery.

What specific risks did the exercise program reduce?

The data indicates that pre-surgery exercise led to lower rates of pneumonia, pulmonary infections, and atelectasis (collapsed lung tissue). These findings were based on a review of 29 different clinical trials involving 2,900 participants.

Is the evidence for these results very strong?

The certainty of the evidence ranges from moderate to very low across different outcomes. Some measurements, like the 6-minute walk distance, were inconsistent because of differences in how they were measured across various trials.

Study Details

Study typeMeta analysis

EvidenceLevel 1

PublishedAug 2026

View Original Abstract ↓

BackgroundPostoperative pulmonary complications (PPCs) are common and clinically important adverse outcomes after lung cancer surgery. Preoperative exercise-based prehabilitation may enhance functional reserve before surgery, but its effects on PPCs and related perioperative outcomes remain uncertain.MethodsThis systematic review and meta-analysis followed the PRISMA 2020 guidelines and was registered with PROSPERO (CRD420251273259). PubMed, Web of Science, Embase, the Cochrane Library, CINAHL, CNKI, Wanfang Data, and the VIP Database were searched from inception to 25 December 2025. Randomized controlled trials evaluating preoperative exercise-based prehabilitation in adults undergoing lung cancer surgery were included. Risk of bias was assessed using the Cochrane RoB 2 tool, and certainty of evidence was assessed using the GRADE approach. Random-effects meta-analyses were performed using RevMan 5.4.1.ResultsA total of 28 reports comprising 29 randomized controlled trials and 2,900 eligible surgical participants were included. Compared with usual perioperative care, preoperative exercise-based prehabilitation significantly reduced the risk of overall PPCs (RR = 0.42, 95% CI 0.33–0.53; I2 = 0%), pneumonia or pulmonary infection (RR = 0.52, 95% CI 0.36–0.75; I2 = 0%), atelectasis (RR = 0.36, 95% CI 0.25–0.51; I2 = 0%), and respiratory failure (RR = 0.37, 95% CI 0.17–0.78; I2 = 0%). Prehabilitation also reduced postoperative length of hospital stay (MD = −2.22 days, 95% CI −2.52 to −1.92; I2 = 52%). Results for preoperative 6-minute walk distance were inconsistent and were summarized narratively because of substantial heterogeneity.ConclusionPreoperative exercise-based prehabilitation may reduce PPCs and shorten postoperative hospital stay after lung cancer surgery, but the certainty of evidence ranged from moderate to very low across outcomes. Evidence for functional improvement remains uncertain. Future multicenter trials should standardize prehabilitation protocols, outcome definitions, safety monitoring, and adherence reporting.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD420251273259.

Preoperative exercise-based prehabilitation reduces postoperative pulmonary complications and hospital stay after lung cancer surgeryExercise Before Surgery May Reduce Lung Cancer Complications

How this fits prior evidence

Common questions

Study Details

Evaluating the Efficacy of Traditional Chinese Medicine Decoctions for Rheumatoid Arthritis Management

Traditional Chinese medicine decoctions may improve rheumatoid arthritis symptoms

Clinical research that matters. Delivered to your inbox.

Preoperative exercise-based prehabilitation reduces postoperative pulmonary complications and hospital stay after lung cancer surgeryExercise Before Surgery May Reduce Lung Cancer Complications

How this fits prior evidence

Common questions

More on Lung Cancer

Study Details

Evaluating the Efficacy of Traditional Chinese Medicine Decoctions for Rheumatoid Arthritis Management

Traditional Chinese medicine decoctions may improve rheumatoid arthritis symptoms

Clinical research that matters. Delivered to your inbox.

Related in Rheumatology

From Other Specialties