To investigate the impact of a multidimensional management model based on prehabilitation and Enhanced Recovery After Surgery (ERAS) protocols on perioperative rehabilitation and prognosis in elderly patients undergoing lung cancer surgery.

Seventy elderly patients who underwent lung cancer resection in our Hospital from January 2022 to December 2024 were enrolled. According to different perioperative management interventions, they were divided into a control group (32 cases) and an observation group (38 cases). Patients in the control group received a prehabilitation program tailored to their comorbidities, including smoking cessation, aerobic exercise, anemia correction, resistance training, inspiratory muscle training, and enhanced psychological support. The observation group received additional interventions aimed at improving functional residual capacity (FRC) and forced expiratory volume in the first second (FEV₁) based on the control group′s protocol. The following parameters were compared between the two groups: time to first ambulation, time to first flatus, postoperative hospital stay, pain visual analogue scale (VAS) scores at different postoperative time points (6 h, 12 h, 24 h, 48 h), incidence of postoperative complications, and survival status during a 3-10 month follow-up.

There was no significant difference in preoperative pulmonary function test results between the two groups (P>0.05). The postoperative recovery process was significantly accelerated in the observation group. The time to first ambulation (28.55±8.33 hours vs. 44.82±12.72 hours), time to first flatus (21.74±4.24 hours vs. 32.91±5.64 hours), and postoperative hospital stay (6.21±1.10 days vs. 9.03±1.93 days) were all significantly shorter in the observation group (P<0.01). VAS pain scores at all measured postoperative time points were significantly lower in the observation group (P<0.05). However, there were no statistically significant differences between the two groups in the incidence of postoperative complications or in survival/mortality rates during the 3-10 month follow-up (P>0.05).

In the perioperative management of elderly lung cancer patients, integrating prehabilitation and ERAS concepts through a multidimensional intervention model can effectively accelerate postoperative recovery, shorten hospital stays, and improve acute postoperative pain control, demonstrating significant clinical value.