Progress in physiotherapy intervention strategies for postoperative pulmonary complications in patients with lung cancer_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

CHEN Shuwan ¹ , WANG Jiao ^2,3 , XU Lin ^2,3 , ZHOU Nanxi ¹ ,  YU Pengming ^2,3

1. School of Clinical Medicine, West China Hospital, Sichuan University, Chengdu, 610041, P. R. China;
2. Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, 610041, P. R. China;
3. Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, 610041, P. R. China;

Corresponding?author：

YU Pengming, Email: 13438201451@126.com

Keywords：

Lung cancer; postoperative pulmonary complications; physical therapy; pulmonary rehabilitation; artificial intelligence; integrated traditional Chinese and Western medicine

DOI：

10.7507/1007-4848.202603074

Video：

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Abstract Full text Figures/Tables Video References Cited by

Postoperative pulmonary complications (PPCs) in patients with lung cancer are a critical issue affecting postoperative recovery and prognosis. In recent years, with the advancement of perioperative management concepts and the development of interdisciplinary collaboration models for lung cancer patients, physiotherapy intervention strategies centered on breathing training, airway clearance, early mobilization, and exercise training have played an important role in reducing PPCs, promoting functional recovery, and lowering hospital readmission rates. This review summarizes recent advances in physiotherapy intervention strategies for PPCs in lung cancer patients. Starting from risk factor identification and the evolution of risk prediction models, it outlines the applications of core techniques including breathing training, airway clearance, and exercise training. Furthermore, it comprehensively discusses innovations in delivery modes, interdisciplinary collaboration, digital rehabilitation based on physiotherapy techniques, and the integration of traditional Chinese and Western medicine. Additionally, it explores new directions such as artificial intelligence empowerment, precision rehabilitation, and patient-clinician co-management, aiming to provide a reference for constructing and implementing a clinical system centered on physiotherapy for the prevention and management of PPCs after lung cancer surgery.

1.	Bray F, Laversanne M, Sung H, et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2024, 74(3): 229-263.
2.	Li C, Lei S, Ding L, et al. Global burden and trends of lung cancer incidence and mortality. Chin Med J (Engl), 2023, 136(13): 1583-1590.
3.	Deng T, Song J, Tuo J, et al. Incidence and risk factors of pulmonary complications after lung cancer surgery: a systematic review and meta-analysis. Heliyon, 2024, 10(12): e32821.
4.	Villeneuve PJ. Interventions to avoid pulmonary complications after lung cancer resection. J Thorac Dis, 2018, 10(Suppl 33): S3781-S3788.
5.	Jammer I, Wickboldt N, Sander M, et al. Standards for definitions and use of outcome measures for clinical effectiveness research in perioperative medicine: European perioperative clinical outcome (EPCO) definitions: a statement from the ESA-ESICM joint taskforce on perioperative outcome measures. Eur J Anaesthesiol, 2015, 32(2): 88-105.
6.	Torres A. Respiratory infections after lung cancer resection. Expert Rev Anti Infect Ther, 2006, 4(5): 717-720.
7.	Alloubi I, Jougon J, Delcambre F, et al. Early complications after pneumonectomy: retrospective study of 168 patients. Interact Cardiovasc Thorac Surg, 2010, 11(2): 162-165.
8.	Fibla JJ, Molins L, Quero F, et al. Perioperative outcome of lung cancer surgery in women: results from a Spanish nationwide prospective cohort study. J Thorac Dis, 2019, 11(4): 1475-1484.
9.	Nakahara K, Ohno K, Hashimoto J, et al. Prediction of postoperative respiratory failure in patients undergoing lung resection for lung cancer. Ann Thorac Surg, 1988, 46(5): 549-552.
10.	Feng G, Jia Y, Zhao G, et al. Risk factors for postoperative pulmonary complications in elderly patients undergoing video-assisted thoracoscopic surgery lobectomy under general anesthesia: a retrospective study. BMC Surg, 2024, 24(1): 153.
11.	Yao L, Luo J, Liu L, et al. Risk factors for postoperative pneumonia and prognosis in lung cancer patients after surgery: a retrospective study. Medicine (Baltimore), 2021, 100(13): e25295.
12.	Sun C, Hirata Y, Kawahara T, et al. Diagnosis of respiratory sarcopenia for stratifying postoperative risk in non-small cell lung cancer. JAMA Surg, 2025, 160(1): 66-73.
13.	Sha Y, Huangfu Z, Gu X, et al. A machine learning-based predictive model for postoperative pulmonary complications in lung cancer and its SHAP interpretation. Front Oncol, 2026, 16: 1749808.
14.	Baar W, Semmelmann A, Knoerlein J, et al. Risk factors for postoperative pulmonary complications leading to increased in-hospital mortality in patients undergoing thoracotomy for primary lung cancer resection: a multicentre retrospective cohort study of the German thorax registry. J Clin Med, 2022, 11(19): 5781.
15.	Piccioni F, Langiano N, Bignami E, et al. One-lung ventilation and postoperative pulmonary complications after major lung resection surgery: a multicenter randomized controlled trial. J Cardiothorac Vasc Anesth, 2023, 37(12): 2561-2571.
16.	Li L, Wu Y, Chen J. Prediction modeling of postoperative pulmonary complications following lung resection based on random forest algorithm. Medicine (Baltimore), 2024, 103(34): e39260.
17.	Huang G, Liu L, Wang L, et al. Prediction of postoperative cardiopulmonary complications after lung resection in a Chinese population: a machine learning-based study. Front Oncol, 2022, 12: 1003722.
18.	Chen S, Deng T, Yang Q, et al. Development and validation of an explainable machine learning model for predicting postoperative pulmonary complications after lung cancer surgery: a machine learning study. EClinicalMedicine, 2025, 86: 103386.
19.	Wang S, Lin Y, Shi H, et al. Prediction model for postoperative pulmonary complications after thoracoscopic surgery with machine learning algorithms and Shapley additive explanations. J Thorac Dis, 2025, 17(6): 3603-3618.
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25.	Jonsson M, Hurtig-Wennl?f A, Ahlsson A, et al. In-hospital physiotherapy improves physical activity level after lung cancer surgery: a randomized controlled trial. Physiotherapy, 2019, 105(4): 434-441.
26.	Liu JF, Kuo NY, Fang TP, et al. A six-week inspiratory muscle training and aerobic exercise improves respiratory muscle strength and exercise capacity in lung cancer patients after video-assisted thoracoscopic surgery: a randomized controlled trial. Clin Rehabil, 2021, 35(6): 840-850.
27.	Pastene B, Labarriere A, Lopez A, et al. Ultra-early initiation of postoperative rehabilitation in the post-anaesthesia care unit after major thoracic surgery: case-control study. BJS Open, 2022, 6(3): zrac085.
28.	Ding X, Zhang H, Liu H. Early ambulation and postoperative recovery of patients with lung cancer under thoracoscopic surgery: an observational study. J Cardiothorac Surg, 2023, 18(1): 136.
29.	Nagamatsu Y, Maeshiro K, Kimura NY, et al. Long-term recovery of exercise capacity and pulmonary function after lobectomy. J Thorac Cardiovasc Surg, 2007, 134(5): 1273-1278.
30.	Pelletier C, Lapointe L, Leblanc P. Effects of lung resection on pulmonary function and exercise capacity. Thorax, 1990, 45(7): 497-502.
31.	Machado P, Pimenta S, Garcia AL, et al. Effect of preoperative home-based exercise training on quality of life after lung cancer surgery: a multicenter randomized controlled trial. Ann Surg Oncol, 2024, 31(2): 847-859.
32.	Karenovics W, Licker M, Ellenberger C, et al. Short-term preoperative exercise therapy does not improve long-term outcome after lung cancer surgery: a randomized controlled study. Eur J Cardiothorac Surg, 2017, 52(1): 47-54.
33.	中國老年保健協會肺癌專業委員會, 四川省康復醫學會加速康復外科分會, 成都康復醫學會肺康復專業委員會, 等. 肺癌圍手術期肺康復訓練中國專家共識. 中國肺癌雜志, 2024, 27(7): 495-503.Lung Cancer Specialty Committee of Chinese Elderly Health Care Association, Enhanced Recovery after Surgery Specialty Committee of Sichuan Province Rehabilitation Medical Association, Lung Rehabilitation Specialty Committee of Chengdu Rehabilitation Medical Association, et al. Chinese expert consensus on perioperative pulmonary rehabilitation training for lung cancer. Chin J Lung Cancer, 2024, 27(7): 495-503.
34.	Batchelor TJP, Rasburn NJ, Abdelnour-Berchtold E, et al. Guidelines for enhanced recovery after lung surgery: recommendations of the Enhanced Recovery after Surgery (ERAS) Society and the European Society of Thoracic Surgeons (ESTS). Eur J Cardiothorac Surg, 2019, 55(1): 91-115.
35.	Wade-McBane K, King A, Urch C, et al. Prehabilitation in the lung cancer pathway: a scoping review. BMC Cancer, 2023, 23(1): 747.
36.	Mohamed EH, Khalid SA, Ul Haq E, et al. Effectiveness of prehabilitation programs in reducing the length of hospital stay and complication rates in major surgeries: a systematic review. Cureus, 2025, 17(1): e76932.
37.	Mania K, Pieczynska A, Hojan K. Comprehensive multimodal prehabilitation for lung cancer: a systematic review of randomized controlled trials. Ther Clin Risk Manag, 2025, 21: 1735-1745.
38.	Ju S, Liu M, Wang B, et al. Transcutaneous electrical acupoint stimulation improves pulmonary function by regulating oxidative stress during one-lung ventilation in patients with lung cancer undergoing thoracoscopic surgery: a randomized controlled trial. BMC Complement Med Ther, 2023, 23(1): 463.
39.	Sun L, Wei X, Wang K, et al. Combined anesthesia of acupuncture-pharmacotherapy in pulmonary resection surgery: systematic review and meta-analysis. Chin Acupunct Moxibustion, 2024, 44(1): 109-122.
40.	Xi Z, Wei X, Ye Z, et al. Acupuncture for adult lung cancer of patient-reported outcomes: a systematic review and meta-analysis. Front Oncol, 2022, 12: 921151.
41.	Cheung CTY, Chan EYF. Postoperative pulmonary complications and their prevention. Anaesth Intensive Care Med, 2022, 23(11): 688-695.
42.	Mendes de Oliveira JC, Studart Leit?o Filho FS, Malosa Sampaio LM, et al. Outpatient vs. home-based pulmonary rehabilitation in COPD: a randomized controlled trial. Multidiscip Respir Med, 2010, 5(6): 401-408.
43.	Vallier JM, Simon C, Bronstein A, et al. Randomized controlled trial of home-based vs. hospital-based pulmonary rehabilitation in post COVID-19 patients. Eur J Phys Rehabil Med, 2023, 59(1): 103-110.
44.	Saito T, Ono R, Tanaka Y, et al. The effect of home-based preoperative pulmonary rehabilitation before lung resection: a retrospective cohort study. Lung Cancer, 2021, 162: 135-139.
45.	Granger CL, Edbrooke L, Antippa P, et al. Home-based exercise and self-management after lung cancer resection: a randomized clinical trial. JAMA Netw Open, 2024, 7(12): e2447325.
46.	van Egmond MA, Engelbert RHH, Klinkenbijl JHG, et al. Physiotherapy with telerehabilitation in patients with complicated postoperative recovery after esophageal cancer surgery: feasibility study. J Med Internet Res, 2020, 22(6): e16056.
47.	Lu T, Deng T, Long Y, et al. Effectiveness and feasibility of digital pulmonary rehabilitation in patients undergoing lung cancer surgery: systematic review and meta-analysis. J Med Internet Res, 2024, 26: e56795.
48.	Agusti A, Bel E, Thomas M, et al. Treatable traits: toward precision medicine of chronic airway diseases. Eur Respir J, 2016, 47(2): 410-419.
49.	McDonald VM, Fingleton J, Agusti A, et al. Treatable traits: a new paradigm for 21st century management of chronic airway diseases: Treatable Traits Down Under International Workshop report. Eur Respir J, 2019, 53(5): 1802058.
50.	Miskovic A, Lumb AB. Postoperative pulmonary complications. BJA, 2017, 118(3): 317-334.
51.	Sarwar MR, McDonald VM, Abramson MJ, et al. Treatable traits in an English cohort: prevalence and predictors of future decline in lung function and quality of life in COPD. ERJ Open Res, 2021, 7(2): 00750-2020.
52.	Hiles SA, Gibson PG, Agusti A, et al. Treatable traits that predict health status and treatment response in airway disease. J Allergy Clin Immunol Pract, 2021, 9(3): 1255-1264.
53.	Chen L, Liu J, Xia H, et al. Intelligent breathing training using a digital device for postoperative lung cancer patients: a randomized controlled trial. Biol Res Nurs, 2026, 28(3): 333-345.
54.	Li M, Zhang H, Xia C, et al. Application practice of AI empowering post-discharge specialized disease management in postoperative rehabilitation of the lung cancer patients undergoing surgery. Chin J Lung Cancer, 2025, 28(3): 176-182.
55.	Malin B, Benitez K, Masys D. Never too old for anonymity: a statistical standard for demographic data sharing via the HIPAA privacy rule. J Am Med Inform Assoc, 2011, 18(1): 3-10.
56.	Rieke N, Hancox J, Li W, et al. The future of digital health with federated learning. NPJ Digit Med, 2020, 3: 119.
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60.	Barry MJ, Edgman-Levitan S. Shared decision making: pinnacle of patient-centered care. N Engl J Med, 2012, 366(9): 780-781.
61.	Charles C, Gafni A, Whelan T. Shared decision-making in the medical encounter: what does it mean? (or it takes at least two to tango). Soc Sci Med, 1997, 44(5): 681-692.
62.	Elwyn G, Frosch D, Thomson R, et al. Shared decision making: a model for clinical practice. J Gen Intern Med, 2012, 27(10): 1361-1367.
63.	肖婷婷, 許麗春, 鄭卉, 等. 肺癌術后患者肺康復行為促進與障礙因素的Meta整合. 中華護理雜志, 2025, 60(18): 2279-2286.Xiao TT, Xu LC, Zheng H, et al. Facilitators and barriers to pulmonary rehabilitation in postoperative lung cancer patients: a meta-synthesis. Chin J Nurs, 2025, 60(18): 2279-2286.

1. Bray F, Laversanne M, Sung H, et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2024, 74(3): 229-263.
2. Li C, Lei S, Ding L, et al. Global burden and trends of lung cancer incidence and mortality. Chin Med J (Engl), 2023, 136(13): 1583-1590.
3. Deng T, Song J, Tuo J, et al. Incidence and risk factors of pulmonary complications after lung cancer surgery: a systematic review and meta-analysis. Heliyon, 2024, 10(12): e32821.
4. Villeneuve PJ. Interventions to avoid pulmonary complications after lung cancer resection. J Thorac Dis, 2018, 10(Suppl 33): S3781-S3788.
5. Jammer I, Wickboldt N, Sander M, et al. Standards for definitions and use of outcome measures for clinical effectiveness research in perioperative medicine: European perioperative clinical outcome (EPCO) definitions: a statement from the ESA-ESICM joint taskforce on perioperative outcome measures. Eur J Anaesthesiol, 2015, 32(2): 88-105.
6. Torres A. Respiratory infections after lung cancer resection. Expert Rev Anti Infect Ther, 2006, 4(5): 717-720.
7. Alloubi I, Jougon J, Delcambre F, et al. Early complications after pneumonectomy: retrospective study of 168 patients. Interact Cardiovasc Thorac Surg, 2010, 11(2): 162-165.
8. Fibla JJ, Molins L, Quero F, et al. Perioperative outcome of lung cancer surgery in women: results from a Spanish nationwide prospective cohort study. J Thorac Dis, 2019, 11(4): 1475-1484.
9. Nakahara K, Ohno K, Hashimoto J, et al. Prediction of postoperative respiratory failure in patients undergoing lung resection for lung cancer. Ann Thorac Surg, 1988, 46(5): 549-552.
10. Feng G, Jia Y, Zhao G, et al. Risk factors for postoperative pulmonary complications in elderly patients undergoing video-assisted thoracoscopic surgery lobectomy under general anesthesia: a retrospective study. BMC Surg, 2024, 24(1): 153.
11. Yao L, Luo J, Liu L, et al. Risk factors for postoperative pneumonia and prognosis in lung cancer patients after surgery: a retrospective study. Medicine (Baltimore), 2021, 100(13): e25295.
12. Sun C, Hirata Y, Kawahara T, et al. Diagnosis of respiratory sarcopenia for stratifying postoperative risk in non-small cell lung cancer. JAMA Surg, 2025, 160(1): 66-73.
13. Sha Y, Huangfu Z, Gu X, et al. A machine learning-based predictive model for postoperative pulmonary complications in lung cancer and its SHAP interpretation. Front Oncol, 2026, 16: 1749808.
14. Baar W, Semmelmann A, Knoerlein J, et al. Risk factors for postoperative pulmonary complications leading to increased in-hospital mortality in patients undergoing thoracotomy for primary lung cancer resection: a multicentre retrospective cohort study of the German thorax registry. J Clin Med, 2022, 11(19): 5781.
15. Piccioni F, Langiano N, Bignami E, et al. One-lung ventilation and postoperative pulmonary complications after major lung resection surgery: a multicenter randomized controlled trial. J Cardiothorac Vasc Anesth, 2023, 37(12): 2561-2571.
16. Li L, Wu Y, Chen J. Prediction modeling of postoperative pulmonary complications following lung resection based on random forest algorithm. Medicine (Baltimore), 2024, 103(34): e39260.
17. Huang G, Liu L, Wang L, et al. Prediction of postoperative cardiopulmonary complications after lung resection in a Chinese population: a machine learning-based study. Front Oncol, 2022, 12: 1003722.
18. Chen S, Deng T, Yang Q, et al. Development and validation of an explainable machine learning model for predicting postoperative pulmonary complications after lung cancer surgery: a machine learning study. EClinicalMedicine, 2025, 86: 103386.
19. Wang S, Lin Y, Shi H, et al. Prediction model for postoperative pulmonary complications after thoracoscopic surgery with machine learning algorithms and Shapley additive explanations. J Thorac Dis, 2025, 17(6): 3603-3618.
20. Wang J, Deng N, Qi F, et al. The effectiveness of postoperative rehabilitation interventions that include breathing exercises to prevent pulmonary atelectasis in lung cancer resection patients: a systematic review and meta-analysis. BMC Pulm Med, 2023, 23(1): 276.
21. Ren J, Li Z, He Y, et al. Systematic review and meta-analysis of breathing exercises effects on lung function and quality of life in postoperative lung cancer patients. J Thorac Dis, 2024, 16(7): 4295-4309.
22. Guo Y, Pan M, Xiong M, et al. Efficacy of preoperative pulmonary rehabilitation in lung cancer patients: a systematic review and meta-analysis of randomized controlled trials. Discov Oncol, 2025, 16(1): 56.
23. Li C, Meng H, Wei Y, et al. Postoperative outcomes of preoperative exercise training in patients with operable non-small cell lung cancer: a systematic review and meta-analysis. Front Oncol, 2025, 15: 1563478.
24. 中華醫學會外科學分會, 中華醫學會麻醉學分會. 中國加速康復外科臨床實踐指南(2021)(一). 協和醫學雜志, 2021, 12(5): 624-631.Chinese Society of Surgery, Chinese Society of Anesthesiology. Clinical practice guidelines for ERAS in China (2021)(Ⅰ). Med J Peking Union Med Coll Hosp, 2021, 12(5): 624-631.
25. Jonsson M, Hurtig-Wennl?f A, Ahlsson A, et al. In-hospital physiotherapy improves physical activity level after lung cancer surgery: a randomized controlled trial. Physiotherapy, 2019, 105(4): 434-441.
26. Liu JF, Kuo NY, Fang TP, et al. A six-week inspiratory muscle training and aerobic exercise improves respiratory muscle strength and exercise capacity in lung cancer patients after video-assisted thoracoscopic surgery: a randomized controlled trial. Clin Rehabil, 2021, 35(6): 840-850.
27. Pastene B, Labarriere A, Lopez A, et al. Ultra-early initiation of postoperative rehabilitation in the post-anaesthesia care unit after major thoracic surgery: case-control study. BJS Open, 2022, 6(3): zrac085.
28. Ding X, Zhang H, Liu H. Early ambulation and postoperative recovery of patients with lung cancer under thoracoscopic surgery: an observational study. J Cardiothorac Surg, 2023, 18(1): 136.
29. Nagamatsu Y, Maeshiro K, Kimura NY, et al. Long-term recovery of exercise capacity and pulmonary function after lobectomy. J Thorac Cardiovasc Surg, 2007, 134(5): 1273-1278.
30. Pelletier C, Lapointe L, Leblanc P. Effects of lung resection on pulmonary function and exercise capacity. Thorax, 1990, 45(7): 497-502.
31. Machado P, Pimenta S, Garcia AL, et al. Effect of preoperative home-based exercise training on quality of life after lung cancer surgery: a multicenter randomized controlled trial. Ann Surg Oncol, 2024, 31(2): 847-859.
32. Karenovics W, Licker M, Ellenberger C, et al. Short-term preoperative exercise therapy does not improve long-term outcome after lung cancer surgery: a randomized controlled study. Eur J Cardiothorac Surg, 2017, 52(1): 47-54.
33. 中國老年保健協會肺癌專業委員會, 四川省康復醫學會加速康復外科分會, 成都康復醫學會肺康復專業委員會, 等. 肺癌圍手術期肺康復訓練中國專家共識. 中國肺癌雜志, 2024, 27(7): 495-503.Lung Cancer Specialty Committee of Chinese Elderly Health Care Association, Enhanced Recovery after Surgery Specialty Committee of Sichuan Province Rehabilitation Medical Association, Lung Rehabilitation Specialty Committee of Chengdu Rehabilitation Medical Association, et al. Chinese expert consensus on perioperative pulmonary rehabilitation training for lung cancer. Chin J Lung Cancer, 2024, 27(7): 495-503.
34. Batchelor TJP, Rasburn NJ, Abdelnour-Berchtold E, et al. Guidelines for enhanced recovery after lung surgery: recommendations of the Enhanced Recovery after Surgery (ERAS) Society and the European Society of Thoracic Surgeons (ESTS). Eur J Cardiothorac Surg, 2019, 55(1): 91-115.
35. Wade-McBane K, King A, Urch C, et al. Prehabilitation in the lung cancer pathway: a scoping review. BMC Cancer, 2023, 23(1): 747.
36. Mohamed EH, Khalid SA, Ul Haq E, et al. Effectiveness of prehabilitation programs in reducing the length of hospital stay and complication rates in major surgeries: a systematic review. Cureus, 2025, 17(1): e76932.
37. Mania K, Pieczynska A, Hojan K. Comprehensive multimodal prehabilitation for lung cancer: a systematic review of randomized controlled trials. Ther Clin Risk Manag, 2025, 21: 1735-1745.
38. Ju S, Liu M, Wang B, et al. Transcutaneous electrical acupoint stimulation improves pulmonary function by regulating oxidative stress during one-lung ventilation in patients with lung cancer undergoing thoracoscopic surgery: a randomized controlled trial. BMC Complement Med Ther, 2023, 23(1): 463.
39. Sun L, Wei X, Wang K, et al. Combined anesthesia of acupuncture-pharmacotherapy in pulmonary resection surgery: systematic review and meta-analysis. Chin Acupunct Moxibustion, 2024, 44(1): 109-122.
40. Xi Z, Wei X, Ye Z, et al. Acupuncture for adult lung cancer of patient-reported outcomes: a systematic review and meta-analysis. Front Oncol, 2022, 12: 921151.
41. Cheung CTY, Chan EYF. Postoperative pulmonary complications and their prevention. Anaesth Intensive Care Med, 2022, 23(11): 688-695.
42. Mendes de Oliveira JC, Studart Leit?o Filho FS, Malosa Sampaio LM, et al. Outpatient vs. home-based pulmonary rehabilitation in COPD: a randomized controlled trial. Multidiscip Respir Med, 2010, 5(6): 401-408.
43. Vallier JM, Simon C, Bronstein A, et al. Randomized controlled trial of home-based vs. hospital-based pulmonary rehabilitation in post COVID-19 patients. Eur J Phys Rehabil Med, 2023, 59(1): 103-110.
44. Saito T, Ono R, Tanaka Y, et al. The effect of home-based preoperative pulmonary rehabilitation before lung resection: a retrospective cohort study. Lung Cancer, 2021, 162: 135-139.
45. Granger CL, Edbrooke L, Antippa P, et al. Home-based exercise and self-management after lung cancer resection: a randomized clinical trial. JAMA Netw Open, 2024, 7(12): e2447325.
46. van Egmond MA, Engelbert RHH, Klinkenbijl JHG, et al. Physiotherapy with telerehabilitation in patients with complicated postoperative recovery after esophageal cancer surgery: feasibility study. J Med Internet Res, 2020, 22(6): e16056.
47. Lu T, Deng T, Long Y, et al. Effectiveness and feasibility of digital pulmonary rehabilitation in patients undergoing lung cancer surgery: systematic review and meta-analysis. J Med Internet Res, 2024, 26: e56795.
48. Agusti A, Bel E, Thomas M, et al. Treatable traits: toward precision medicine of chronic airway diseases. Eur Respir J, 2016, 47(2): 410-419.
49. McDonald VM, Fingleton J, Agusti A, et al. Treatable traits: a new paradigm for 21st century management of chronic airway diseases: Treatable Traits Down Under International Workshop report. Eur Respir J, 2019, 53(5): 1802058.
50. Miskovic A, Lumb AB. Postoperative pulmonary complications. BJA, 2017, 118(3): 317-334.
51. Sarwar MR, McDonald VM, Abramson MJ, et al. Treatable traits in an English cohort: prevalence and predictors of future decline in lung function and quality of life in COPD. ERJ Open Res, 2021, 7(2): 00750-2020.
52. Hiles SA, Gibson PG, Agusti A, et al. Treatable traits that predict health status and treatment response in airway disease. J Allergy Clin Immunol Pract, 2021, 9(3): 1255-1264.
53. Chen L, Liu J, Xia H, et al. Intelligent breathing training using a digital device for postoperative lung cancer patients: a randomized controlled trial. Biol Res Nurs, 2026, 28(3): 333-345.
54. Li M, Zhang H, Xia C, et al. Application practice of AI empowering post-discharge specialized disease management in postoperative rehabilitation of the lung cancer patients undergoing surgery. Chin J Lung Cancer, 2025, 28(3): 176-182.
55. Malin B, Benitez K, Masys D. Never too old for anonymity: a statistical standard for demographic data sharing via the HIPAA privacy rule. J Am Med Inform Assoc, 2011, 18(1): 3-10.
56. Rieke N, Hancox J, Li W, et al. The future of digital health with federated learning. NPJ Digit Med, 2020, 3: 119.
57. Sacristán JA. Patient-centered medicine and patient-oriented research: improving health outcomes for individual patients. BMC Med Inform Decis Mak, 2013, 13: 6.
58. Laine C, Davidoff F. Patient-centered medicine: a professional evolution. JAMA, 1996, 275(2): 152-156.
59. Mead N, Bower P. Patient-centredness: a conceptual framework and review of the empirical literature. Soc Sci Med, 2000, 51(7): 1087-1110.
60. Barry MJ, Edgman-Levitan S. Shared decision making: pinnacle of patient-centered care. N Engl J Med, 2012, 366(9): 780-781.
61. Charles C, Gafni A, Whelan T. Shared decision-making in the medical encounter: what does it mean? (or it takes at least two to tango). Soc Sci Med, 1997, 44(5): 681-692.
62. Elwyn G, Frosch D, Thomson R, et al. Shared decision making: a model for clinical practice. J Gen Intern Med, 2012, 27(10): 1361-1367.
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