Impact of an enhanced recovery after surgery pathway on thoracoscopic lobectomy outcomes in non-small cell lung cancer patients: a propensity score-matched study.

Autor:	Forster C; Service of Thoracic Surgery, University Hospital of Lausanne (CHUV), Lausanne, Switzerland., Doucet V; Service of Thoracic Surgery, University Hospital of Lausanne (CHUV), Lausanne, Switzerland., Perentes JY; Service of Thoracic Surgery, University Hospital of Lausanne (CHUV), Lausanne, Switzerland.; University of Lausanne, Lausanne, Switzerland., Abdelnour-Berchtold E; Service of Thoracic Surgery, University Hospital of Lausanne (CHUV), Lausanne, Switzerland., Zellweger M; Service of Thoracic Surgery, University Hospital of Lausanne (CHUV), Lausanne, Switzerland., Faouzi M; Division of Biostatistics, Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland., Bouchaab H; Service of Medical Oncology, University Hospital of Lausanne (CHUV), Lausanne, Switzerland., Peters S; University of Lausanne, Lausanne, Switzerland.; Service of Medical Oncology, University Hospital of Lausanne (CHUV), Lausanne, Switzerland., Marcucci C; University of Lausanne, Lausanne, Switzerland.; Service of Anesthesiology, University Hospital of Lausanne (CHUV), Lausanne, Switzerland., Krueger T; Service of Thoracic Surgery, University Hospital of Lausanne (CHUV), Lausanne, Switzerland.; University of Lausanne, Lausanne, Switzerland., Rosner L; Service of Anesthesiology, University Hospital of Lausanne (CHUV), Lausanne, Switzerland., Gonzalez M; Service of Thoracic Surgery, University Hospital of Lausanne (CHUV), Lausanne, Switzerland.; University of Lausanne, Lausanne, Switzerland.
Jazyk:	angličtina
Zdroj:	Translational lung cancer research [Transl Lung Cancer Res] 2021 Jan; Vol. 10 (1), pp. 93-103.
DOI:	10.21037/tlcr-20-891
Abstrakt:	Background: This study evaluates the effect of enhanced recovery after surgery (ERAS) pathways on postoperative outcomes of non-small cell lung cancer (NSCLC) patients undergoing video-assisted thoracic surgery (VATS) lobectomy. Methods: We retrospectively reviewed all consecutive patients undergoing VATS lobectomy for NSCLC between January 2014 and October 2019 and assigned them to the relevant group ("pre-ERAS" or "ERAS"). Length of stay, readmissions and complications within 30 days were compared between both groups. A propensity score-matched analysis was performed based on sex, age, type of operation, comorbidities, American Society of Anesthesiologists (ASA) score and preoperative pulmonary functions. Results: A total of 307 records (164 male/143 female; 140 ERAS/167 pre-ERAS; median age: 67) were reviewed. There was no statistical difference in patient's characteristics. Overall ERAS compliance was 81%. The ERAS group presented significantly shorter length of stay (median 5 vs. 7 days; P=0.004) without significant difference in cardiopulmonary complication rate (27.1% vs. 35.9%; P=0.1). Readmission (3.6% vs. 5.4%; P=0.75) and duration of drainage (median 2 vs. 3 days; P=0.14) were similar between groups. The propensity score-matched analysis showed that the length of hospital stay was reduced by 1.4 days (P=0.034) and the postoperative cardiopulmonary complication rate by 13% (P=0.044) in the ERAS group. Conclusions: Adoption of an ERAS pathway for VATS lobectomies in NSCLC patients has decreased the length of hospital stay and the cardiopulmonary complication rate without affecting the readmission rate. Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/tlcr-20-891). The authors have no conflicts of interest to declare. (2021 Translational Lung Cancer Research. All rights reserved.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu