Introduction Exercise training before lung resection for non-small cell lung cancer is believed to decrease postoperative complications (POC) by improving cardiorespiratory fitness. However, this intervention lacks a strong evidence base. Aim To assess the effectiveness of preoperative exercise training compared with usual care on POC and other secondary outcomes in patients with scheduled lung resection. Methods A systematic search of randomised trials was conducted by two authors. Meta-analysis was performed, and the effect of exercise training was estimated by risk ratios (RR) and mean differences, with their CIs. Clinical usefulness was estimated according to minimal important difference values (MID). Results Fourteen studies involving 791 participants were included. Compared with usual care, exercise training reduced overall POC (10 studies, 617 participants, RR 0.58, 95% CI 0.45 to 0.75) and clinically relevant POC (4 studies, 302 participants, Clavien-Dindo score ≥2 RR 0.42, 95% CI 0.25 to 0.69). The estimate of the effect of exercise training on mortality was very imprecise (6 studies, 456 participants, RR 0.66, 95% CI 0.20 to 2.22). The main risks of bias were a lack of participant blinding and selective reporting. Exercise training appeared to improve exercise capacity, pulmonary function and also quality of life and depression, although the clinical usefulness of the changes was unclear. The quality of the evidence was graded for each outcome. Conclusion Preoperative exercise training leads to a worthwhile reduction in postoperative complications. These estimates were both accurate and large enough to make recommendations for clinical practice. Data are available on reasonable request. All data relevant to the study are included in the article or uploaded as supplementary information. Other supplementary data are available on reasonable request.

中文翻译：

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肺切除前运动训练对非小细胞肺癌患者的影响：系统评价和荟萃分析

简介 非小细胞肺癌肺切除术前的运动训练被认为可以通过改善心肺健康来减少术后并发症 (POC)。然而，这种干预缺乏强有力的证据基础。目的 评估术前运动训练与常规护理相比对计划肺切除患者的 POC 和其他次要结果的有效性。方法 两位作者对随机试验进行了系统检索。进行了荟萃分析，并通过风险比 (RR) 和均值差及其 CI 来估计运动训练的效果。根据最小重要差异值 (MID) 估计临床有用性。结果 共纳入 14 项研究，涉及 791 名参与者。与常规护理相比，运动训练降低了总体 POC（10 项研究，617 名参与者，RR 0.58，95% CI 0.45 至 0.75）和临床相关 POC（4 项研究，302 名参与者，Clavien-Dindo 评分≥2 RR 0.42，95% CI 0.25 至 0.69）。运动训练对死亡率影响的估计非常不精确（6 项研究，456 名参与者，RR 0.66，95% CI 0.20 至 2.22）。偏倚的主要风险是缺乏参与者盲法和选择性报告。运动训练似乎可以改善运动能力、肺功能以及生活质量和抑郁症，尽管这些变化的临床有用性尚不清楚。对每个结果的证据质量进行分级。结论 术前运动训练有助于减少术后并发症。这些估计既准确又足够大，可以为临床实践提出建议。可根据合理要求提供数据。所有与研究相关的数据都包含在文章中或作为补充信息上传。其他补充数据可根据合理要求提供。