scholarly journals Influence of enhanced recovery after surgery (ERAS) on patients receiving lung resection: a retrospective study of 1,749 cases

2020 ◽  
Author(s):  
Chunmei Wang ◽  
Yutian Lai ◽  
Pengfei Li ◽  
Jianhua Su ◽  
Guowei Che
Keyword(s):  
Lung Cancer ◽  
Logistic Regression ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Lung Resection ◽  
Hospital Costs ◽  
Lung Cancer Surgery ◽  
Pulmonary Complications ◽  
Hospital Length Of Stay ◽  
Postoperative Pulmonary Complications

Abstract Background The study aimed to evaluate the outcomes following the implementation of enhanced recovery after surgery (ERAS) for patients undergoing lung cancer surgery.Method A retrospective cohort study involving 1,749 patients with lung cancer undergoing pulmonary resection was conducted. The patients were divided into two time period groups for analysis (routine pathway and ERAS pathway). Logistic regression analysis was performed to assess the risks of developing postoperative pulmonary complications.Results Among the 1,749 patients, 691 were stratified into the ERAS group, and 1,058 in to the routine group. The ERAS group presented with shorter postoperative in-hospital length of stay (LOS) (4.0 vs 6.0, P<0.001), total LOS (10.0 VS. 13.0 days, P<0.001), and lower total in-hospital costs (P<0.001), including material (P<0.001) and drug expenses (P<0.001). Furthermore, the ERAS group also presented with a lower occurrence of postoperative pulmonary complications (PPCs) than the routine group (15.2% vs. 19.5%, P=0.022). Likewise, a significantly lower occurrence of pneumonia (8.4% vs. 14.2%, P<0.001) and atelectasis (5.9% vs. 9.8%, P=0.004) was found in the ERAS group. Regarding the binary logistic regression, the ERAS intervention was the sole independent factor for the occurrence of PPCs (OR: 0.601, 95% CI: 0.434-0.824, P=0.002). In addition, age (OR: 1.032, 95% CI: 1.018-1.046), COPD (OR: 1.792, 95% CI: 1.196-2.686), and FEV1(OR: 0.205, 95% CI: 0.125-0.339) were also independent predictors of PPCs. Conclusion Implementation of an ERAS pathway shows improved postoperative outcomes, including shortened LOS, lower in-hospital costs, and reduced occurrence of PPCs, providing benefits to the postoperative recovery of patients with lung cancer undergoing surgical treatment.

scholarly journals Influence of enhanced recovery after surgery (ERAS) on patients receiving lung resection: a retrospective study of 1749 cases

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Chunmei Wang ◽  
Yutian Lai ◽  
Pengfei Li ◽  
Jianhuan Su ◽  
Guowei Che
Keyword(s):  
Lung Cancer ◽  
Logistic Regression ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Lung Resection ◽  
Hospital Costs ◽  
Lung Cancer Surgery ◽  
Pulmonary Complications ◽  
Hospital Length Of Stay ◽  
Postoperative Pulmonary Complications

Abstract Background The study aimed to evaluate the outcomes following the implementation of enhanced recovery after surgery (ERAS) for patients undergoing lung cancer surgery. Method A retrospective cohort study involving 1749 patients with lung cancer undergoing pulmonary resection was conducted. The patients were divided into two time period groups for analysis (routine pathway and ERAS pathway). Logistic regression analysis was performed to assess the risks of developing postoperative pulmonary complications. Results Among the 1749 patients, 691 were stratified into the ERAS group, and 1058 in to the routine group. The ERAS group presented with shorter postoperative in-hospital length of stay (LOS) (4.0 vs 6.0, P < 0.001), total LOS (10.0 vs. 13.0 days, P < 0.001), and lower total in-hospital costs (P < 0.001), including material (P < 0.001) and drug expenses (P < 0.001). Furthermore, the ERAS group also presented with a lower occurrence of postoperative pulmonary complications (PPCs) than the routine group (15.2% vs. 19.5%, P = 0.022). Likewise, a significantly lower occurrence of pneumonia (8.4% vs. 14.2%, P < 0.001) and atelectasis (5.9% vs. 9.8%, P = 0.004) was found in the ERAS group. Regarding the binary logistic regression, the ERAS intervention was the sole independent factor for the occurrence of PPCs (OR: 0.601, 95% CI 0.434–0.824, P = 0.002). In addition, age (OR: 1.032, 95% CI 1.018–1.046), COPD (OR: 1.792, 95% CI 1.196–2.686), and FEV1 (OR: 0.205, 95% CI 0.125–0.339) were also independent predictors of PPCs. Conclusion Implementation of an ERAS pathway shows improved postoperative outcomes, including shortened LOS, lower in-hospital costs, and reduced occurrence of PPCs, providing benefits to the postoperative recovery of patients with lung cancer undergoing surgical treatment.

scholarly journals Influence of enhanced recovery after surgery (ERAS) on patients receiving lung resection: a retrospective study of 1,749 cases

2020 ◽  
Author(s):  
Chunmei Wang ◽  
Yutian Lai ◽  
Pengfei Li ◽  
Jianhua Su ◽  
Guowei Che
Keyword(s):  
Lung Cancer ◽  
Logistic Regression ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Lung Resection ◽  
Hospital Costs ◽  
Lung Cancer Surgery ◽  
Pulmonary Complications ◽  
Hospital Length Of Stay ◽  
Postoperative Pulmonary Complications

Abstract Background The study aimed to evaluate the outcomes following the implementation of enhanced recovery after surgery (ERAS) for patients undergoing lung cancer surgery.Method A retrospective cohort study involving 1,749 patients with lung cancer undergoing pulmonary resection was conducted. The patients were divided into two time period groups for analysis(routine pathway and ERAS pathway). Logistic regression analysis was performed to assess the risks of developing postoperative pulmonary complications.Results Among the 1,749 patients, 691 were stratified into the ERAS group, and 1,058 in to the routine group. The ERAS group presented with shorter postoperative in-hospital length of stay (LOS) (4.0 vs 6.0, P<0.001), total LOS (10.0 VS. 13.0 days, P<0.001), and lower total in-hospital costs (P<0.001), including material (P<0.001) and drug expenses (P<0.001). Furthermore, the ERAS group also presented with a lower occurrence of postoperative pulmonary complications (PPCs) than the routine group (15.2% vs. 19.5%, P=0.022). Likewise, a significantly lower occurrence of pneumonia (8.4% vs. 14.2%, P<0.001) and atelectasis (5.9% vs. 9.8%, P=0.004) was found in the ERAS group. Regarding the binary logistic regression, the ERAS intervention was the sole independent factor for the occurrence of PPCs (OR: 0.601, 95% CI: 0.434-0.824, P=0.002). In addition, age (OR: 1.032, 95% CI: 1.018-1.046), COPD (OR: 1.792, 95% CI: 1.196-2.686), and FEV1(OR: 0.205, 95% CI: 0.125-0.339) were also independent predictors of PPCs. Conclusion Implementation of an ERAS pathway shows improved postoperative outcomes, including shortened LOS, lower in-hospital costs, and reduced occurrence of PPCs, providing benefits to the postoperative recovery of patients with lung cancer undergoing surgical treatment.

scholarly journals Influence of enhanced recovery after surgery (ERAS) on patients receiving lung resection: a retrospective study of 1,749 cases

2020 ◽  
Author(s):  
Chunmei Wang ◽  
Yutian Lai ◽  
Pengfei Li ◽  
Jianhua Su ◽  
Guowei Che
Keyword(s):  
Lung Cancer ◽  
Logistic Regression ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Lung Resection ◽  
Hospital Costs ◽  
Lung Cancer Surgery ◽  
Pulmonary Complications ◽  
Hospital Length Of Stay ◽  
Postoperative Pulmonary Complications

Abstract Background The study aimed to evaluate the outcomes following the implementation of enhanced recovery after surgery (ERAS) for patients undergoing lung cancer surgery.Method A retrospective cohort study involving 1,749 patients with lung cancer undergoing pulmonary resection was conducted. The patients were divided into two time period groups for analysis(routine pathway and ERAS pathway). Logistic regression analysis was performed to assess the risks of developing postoperative pulmonary complications.Results Among the 1,749 patients, 691 were stratified into the ERAS group, and 1,058 in to the routine group. The ERAS group presented with shorter postoperative in-hospital length of stay (LOS) (4.0 vs 6.0, P<0.001), total LOS (10.0 VS. 13.0 days, P<0.001), and lower total in-hospital costs (P<0.001), including material (P<0.001) and drug expenses (P<0.001). Furthermore, the ERAS group also presented with a lower occurrence of postoperative pulmonary complications (PPCs) than the routine group (15.2% vs. 19.5%, P=0.022). Likewise, a significantly lower occurrence of pneumonia (8.4% vs. 14.2%, P<0.001) and atelectasis (5.9% vs. 9.8%, P=0.004) was found in the ERAS group. Regarding the binary logistic regression, the ERAS intervention was the sole independent factor for the occurrence of PPCs (OR: 0.601, 95% CI: 0.434-0.824, P=0.002). In addition, age (OR: 1.032, 95% CI: 1.018-1.046), COPD (OR: 1.792, 95% CI: 1.196-2.686), and FEV1(OR: 0.205, 95% CI: 0.125-0.339) were also independent predictors of PPCs. Conclusion Implementation of an ERAS pathway shows improved postoperative outcomes, including shortened LOS, lower in-hospital costs, and reduced occurrence of PPCs, providing benefits to the postoperative recovery of patients with lung cancer undergoing surgical treatment.

scholarly journals Influence of Enhanced Recovery After Surgery (ERAS) on Patients Receiving Lung Resection: A Retrospective Study with 1,749 Cases

2020 ◽  
Author(s):  
Chunmei Wang ◽  
Yutian Lai ◽  
Pengfei Li ◽  
Jianhua Su ◽  
Guowei Che
Keyword(s):  
Lung Cancer ◽  
Logistic Regression ◽  
Hospital Cost ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Lung Resection ◽  
Lung Cancer Surgery ◽  
Pulmonary Complications ◽  
Hospital Length Of Stay ◽  
Postoperative Pulmonary Complications

Abstract Background the study was aimed to evaluate the outcomes following implementation of enhanced recovery after surgery (ERAS) in patients undergoing lung cancer surgery.Method a retrospective cohort study with 1,749 patients with lung cancer undergoing pulmonary resection was conducted. Two time period of the patients were included for analyzing (routine pathway and ERAS pathway). Logistic regression analysis and nomogram model was created respectively to assess the risks of postoperative pulmonary complications.Results Among those 1,749 patients, 691 of them was stratified into ERAS group, compared to 1,058 in routine group. ERAS group presented shorter postoperative in-hospital length of stay (LOS) (4.0 vs 6.0, P<0.001), total LOS (10.0 VS. 13.0 days, P<0.001), lower total in-hospital cost (P<0.001) including material (P<0.001), and drug expense (P<0.001). Meanwhile, ERAS group presented lower occurrence of postoperative pulmonary complications (PPCs) compared to routine group (15.2% vs. 19.5%, P=0.022). Likewise, a significantly lower occurrence of pneumonia (8.4% vs. 14.2%, P<0.001) or atelectasis (5.9% vs. 9.8%, P=0.004) was found in ERAS group. Regarding to Binary logistic regression, ERAS intervention was the independent factor for the occurrence of PPCs (OR: 0.601, 95%CI: 0.434-0.824, P=0.002). In addition, age (OR: 1.032, 95%CI: 1.018-1.046), COPD (OR: 1.792, 95%CI: 1.196-2.686), and FEV1(OR: 0.205, 95%CI: 0.125-0.339) were independent predictors for PPCs. A nomogram with a C-index of 0.663 was constructed.Conclusion implementation of an ERAS pathway shows improved postoperative outcomes including shortened LOS, less in-hospital cost, and reduced occurrence of PPCs, providing benefits of postoperative recovery for patients with lung cancer undergoing surgical treatment.Clinical registration number: ChiCTR1900022478

scholarly journals Effect of intraoperative blood loss on postoperative pulmonary complications in patients undergoing video-assisted thoracoscopic surgery

2021 ◽  
Vol 29 (3) ◽  
pp. 347-353
Author(s):  
Lijun Yao ◽  
Weiwei Wang
Keyword(s):  
Lung Cancer ◽  
Propensity Score ◽  
Blood Loss ◽  
Cell Lung Cancer ◽  
Lung Resection ◽  
Pulmonary Complications ◽  
Small Cell ◽  
Intraoperative Blood Loss ◽  
Postoperative Pulmonary Complications ◽  
Small Cell Lung

Background: We aimed to investigate the impact of intraoperative blood loss on postoperative pulmonary complications in patients who underwent video-assisted thoracoscopic lobectomy for nonsmall cell lung cancer. Methods: Data of a total of 409 patients (227 males, 182 females; median age: 62 years; range, 20 to 86 years) who underwent lung resection for Stage I-IIIa non-small cell lung cancer in our clinic between July 2017 and April 2018 were retrospectively analyzed. The receiver operating characteristic analysis was used to confirm the threshold value of intraoperative blood loss for the prediction of postoperative pulmonary complications. Propensity score matching was performed to compare between high-intraoperative blood loss and low-intraoperative blood loss groups. A post-matching conditional logistic regression was conducted to determine the independent risk factors for postoperative pulmonary complications. Results: Of the patients, 86 (21.03%) developed postoperative pulmonary complications. In the propensity score matching analysis, intraoperative blood loss was shown to be a predictive factor of postoperative pulmonary complications (3.992; 95% confidence interval [CI]: 1.54-10.35; p=0.004). The rate of postoperative pulmonary complications in high-intraoperative blood loss group was significantly higher than that the low-intraoperative blood loss group (37.5% vs. 13.9%, respectively; p=0.003). The postoperative length of stay and duration of postoperative antibiotic use were significantly prolonged in the high-intraoperative blood loss group. Conclusion: Intraoperative blood loss serves as a significant risk factor for postoperative pulmonary complications after lung resection for non-small cell lung cancer. Surgeons should strive to reduce intraoperative blood loss for better surgical outcomes.

scholarly journals Key components of enhanced recovery after surgery protocol in lung cancer surgery

2021 ◽  
Vol 8 (3) ◽  
pp. 70-83
Author(s):  
A. K. Каchur ◽  
V. K. Lyadov
Keyword(s):  
Lung Cancer ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Lung Cancer Surgery ◽  
Postoperative Mortality ◽  
Early Mobilization ◽  
Cancer Surgery ◽  
Thoracoscopic Approach ◽  
Thoracic Cancer ◽  
Eras Protocol

Due to the high lung cancer morbidity and the need for surgical intervention in that patient population, introduction of the concept of standard protocol for enhanced recovery after surgery (ERAS) may lead to a significant decrease of the rate of postoperative complications and hospital stay. The aim of the review was to assess the main components of ERAS protocol in thoracic cancer surgery using video-assisted thoracoscopic interventions (VATS). Systematic implementation of specific measures in pre- (patient consulting before the intervention, compliance with fluid and nutrition regimen, exclusion of routine sedation, prophylaxis of venous thrombosis, use of intravenous antibiotics and alcohol skin-prepping solution with chlorohexidine), intra- (prevention of hypothermia, thoracoscopic approach, single-tube approach in anatomic lung resections, exclusion of pleural tube insertion, urethral catheterization for less than 2 hours and only in case of epidural anesthesia) and postoperative (early mobilization and cessation of intravenous infusion, pain control using combination of acetaminophen with NSAIDs, maintenance of normovolemy, use of balanced crystalloid solutions and non-pharmacological measures for nausea and vomiting control) periods promote improved outcomes, decrease of postoperative complication rate and postoperative mortality

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