Systematic Review: Effectiveness of Early Chest Physiotherapy in Preventing Postoperative Pulmonary Complications in Patients Undergoing Thoracic or Abdominal Surgery

Background: Postoperative pulmonary complications (PPCs) are a common concern in patients undergoing thoracic or abdominal surgery, contributing to increased morbidity, extended hospital stays, and elevated healthcare costs. Early initiation of chest physiotherapy (CPT) has been proposed as a strategy to reduce the incidence of PPCs by enhancing respiratory function through various techniques, such as deep breathing exercises, incentive spirometry, and airway clearance. Materials and Methods: This systematic review was conducted following PRISMA guidelines. A comprehensive search was performed across multiple databases, including PubMed, Cochrane Library, Embase, and Scopus, to identify studies assessing the effectiveness of early CPT in reducing PPCs. Studies were screened and selected based on predetermined inclusion criteria focusing on adults undergoing thoracic or abdominal surgery who received CPT within the first 24–48 hours postoperatively. Data extraction and quality assessments were conducted using standardized tools to evaluate study bias and reliability. Results: The review included 12 studies, comprising randomized controlled trials and observational studies. Most studies demonstrated that early CPT significantly reduces the incidence of PPCs, such as atelectasis and pneumonia, and improves lung function. However, the degree of effectiveness varied based on the CPT techniques and timing. Some studies highlighted reductions in hospital stay and ICU admissions, underscoring CPT's potential for improving overall surgical outcomes. Conclusion: Chest physiotherapy after induction of surgery seems to be an efficient method for the prevention of postoperative pulmonary complications in patients who underwent thoracic and abdominal surgery. The results provide evidence for integrating CPT into the postoperative care pathways but the differences in CPT application imply that individualized strategies should be used depending on the patient characteristics and types of surgery. More work needs to be done to support such gains and fine-tune CPT procedure.