The management of day surgery in minimally invasive surgery for 517 patients with early-stage lung cancer by enhanced recovery after surgery_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

XIE Dong ¹ , CHEN Chang ¹ , ZHU Yuming ¹ , LIN Weikang ¹ , SU Hang ¹ , CAO Weijun ^2,3 , CHEN Shanhao ³ , XU Xin ³ , SHE Yunlang ¹ , WANG Haifeng ¹ , HE Wenxin ¹ , JIANG Gening ¹ ,  AI Kaixing ¹

1. Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University, Shanghai, 200433, P.R. China;
2. Department of Respiratory Medicine, Shanghai Pulmonary Hospital, Tongji University, Shanghai, 200433, P.R. China;
3. Medical Department, Shanghai Pulmonary Hospital, Tongji University, Shanghai, 200433, P.R. China;

Corresponding author：

AI Kaixing, Email: akxing8258@tongji.edu.cn

Keywords：

Day surgery; enhanced recovery after surgery; early-stagy lung cancer; minimally invasive surgery

DOI：

10.7507/1007-4848.202012003

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To evaluate the safety and effect of day surgery in minimally invasive surgical treatment of early-stage lung cancer by enhanced recovery after surgery (ERAS).Methods We included the patients discharged from the day surgery ward of thoracic surgery after surgery in Shanghai Pulmonary Hospital between June and November 2019. We retrospectively analyzed surgical indications of day surgery, management and perioperative medical history of the patients. A total of 517 patients were included, with 156 male and 361 female patients aged 46.4±10.9 years. A total of 45 patients underwent single port VATS segmentectomy and 472 patients underwent single port VATS wedge resection.Results The average operation duration was 33.7±18.5 min. The average intraoperative blood loss was 28.5±21.4 mL. There was no intraoperative blood transfusion or conversion to thoracotomy. Postoperative pain score was 2.1±0.2. The average hospitalization was 1.94±0.89 days. The total hospitalization cost of the patients was 34686.51±6228.09 Yuan, which was 29.93% lower than the same surgery methods in the general ward. A percentage of 98.2% patients were satisfied or very satisfied in the patient satisfaction survey.Conclusion Day surgery and ERAS are effective and safe in minimally invasive surgery of early-stage lung cancer. It can also speed up the postoperative recovery of patients, improve the occupancy efficiency of hospital beds and save the medical cost.

1.	陈善豪, 赵昂, 江森, 等. 基于专科病种的日间介入手术模式探索与实践. 现代医院管理, 2019, 17(1): 29-31.
2.	张磊, 王小成, 赵晓燕, 等. 四川大学华西医院日间手术临床路径管理基本规范. 华西医学, 2019, 34(2): 150-154.
3.	Ljungqvist O, Scott M, Fearon KC. Enhanced recovery after surgery: A review. JAMA Surg, 2017, 152(3): 292-298.
4.	姜格宁, 陈昶, 朱余明等. 上海市肺科医院磨玻璃结节早期肺腺癌的诊疗共识(第一版). 中国肺癌杂志, 2018, 21(3): 147-159.
5.	Lee HW, Jin KN, Lee JK, et al. Long-term follow-up of ground-glass nodules after 5 years of stability. J Thorac Oncol, 2019, 14(8): 1370-1377.
6.	Chiang XH, Hsu HH, Hsieh MS, et al. Propensity-matched analysis comparing survival after sublobar resection and lobectomy for ct1n0 lung adenocarcinoma. Ann Surg Oncol, 2019, 27(3): 703-715.
7.	Zhu E, Xie H, Dai C, et al. Intraoperatively measured tumor size and frozen section results should be considered jointly to predict the final pathology for lung adenocarcinoma. Mod Pathol, 2018, 31(9): 1391-1399.
8.	朱泳樵, 黄佳, 林皓, 等. 机器人辅助下胸腔镜手术(RATS)与传统胸腔镜手术(VATS)术后患者疼痛情况的比较研究. 中国胸心血管外科临床杂志, 2015, 22(12): 1095-1099.
9.	Fox JP, Vashi AA, Ross JS, et al. Hospital-based, acute care after ambulatory surgery center discharge. Surgery, 2014, 155(5): 743-753.
10.	中国日间手术合作联盟. 直肠肛门日间手术临床实践指南(2019 版). 中国普通外科杂志, 2019, 28(11): 1322-1355.
11.	石天晓, 顾潇怡, 于海峰, 等. 国内日间手术实践成效与推广建议. 现代医院管理, 2017, 15(6): 46-48.
12.	嵇武, 刘亚萍, 戴玮. 我国日间手术开展现状与前景展望. 中国实用外科杂志, 2020, 40(2): 199-202.
13.	Xie D, Wu J, Hu X, et al. Uniportal versus multiportal video-assisted thoracoscopic surgery does not compromise the outcome of segmentectomy. Eur J Cardio-thorac Surg, 2020: ezaa372.
14.	Song C, Shargall Y, Li H, et al. Prevalence of venous thromboembolism after lung surgery in China: a single-centre, prospective cohort study involving patients undergoing lung resections without perioperative venous thromboembolism prophylaxis. Eur J Cardio-thorac Surg, 2019, 55(3): 455-460.
15.	田博, 宋春凤, 李辉, 等. Caprini 和 Rogers 风险评估模型联合使用可以提高胸外科术后患者筛选静脉血栓栓塞症的准确性. 中华胸部外科电子杂志, 2017, 4(3): 186-189.
16.	Gould MK, Garcia DA, Wren SM, et al. Prevention of VTE in nonorthopedic surgical patients: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest, 2012, 141(2 Suppl): e227S-e277S.
17.	Bahl V, Hu HM, Henke PK, et al. A validation study of a retrospective venous thromboembolism risk scoring method. Ann Surg, 2010, 251(2): 344-350.
18.	Pannucci CJ, Bailey SH, Dreszer G, et al. Validation of the caprini risk assessment model in plastic and reconstructive surgery patients. J Am Coll Sur, 2011, 212(1): 105-112.
19.	李辉, 姜格宁, 中国胸外科静脉血栓栓塞症研究协作组. 胸部恶性肿瘤围术期静脉血栓栓塞症预防中国专家共识(2018 版). 中国肺癌杂志, 2018, 21(10): 739-752.
20.	李玉萍, 谢冬, 杨健, 等. 肺部磨玻璃结节术后急性肺动脉栓塞的防治策略. 中国胸心血管外科临床杂志, 2020, 27(4): 465-470.
21.	Farge D, Bounameaux H, Brenner B, et al. International clinical practice guidelines including guidance for direct oral anticoagulants in the treatment and prophylaxis of venous thromboembolism in patients with cancer. The Lancet Oncol, 2016, 17(10): e452-e466.
22.	车国卫. 加速康复外科: 肺癌手术日间化现状与策略. 中国肺癌杂志, 2020, 23(1): 1-4.
23.	Xie D, Wang H, Fei K, et al. Single-port video-assisted thoracic surgery in 1063 cases: a single-institution experiencedagger. Eur J Cardio-thorac Sur, 2016, 49(Suppl 1): i31-i36.
24.	Meltzer MI. Introduction to health economics for physicians. Lancet, 2001, 358(9286): 993-998.
25.	沈诚, 常帅, 周坤, 等. 加速康复外科和日间手术模式在胸外科中的应用现状及发展前景. 中国肺癌杂志, 2020, 23(9): 800-805.

1. 陈善豪, 赵昂, 江森, 等. 基于专科病种的日间介入手术模式探索与实践. 现代医院管理, 2019, 17(1): 29-31.
2. 张磊, 王小成, 赵晓燕, 等. 四川大学华西医院日间手术临床路径管理基本规范. 华西医学, 2019, 34(2): 150-154.
3. Ljungqvist O, Scott M, Fearon KC. Enhanced recovery after surgery: A review. JAMA Surg, 2017, 152(3): 292-298.
4. 姜格宁, 陈昶, 朱余明等. 上海市肺科医院磨玻璃结节早期肺腺癌的诊疗共识(第一版). 中国肺癌杂志, 2018, 21(3): 147-159.
5. Lee HW, Jin KN, Lee JK, et al. Long-term follow-up of ground-glass nodules after 5 years of stability. J Thorac Oncol, 2019, 14(8): 1370-1377.
6. Chiang XH, Hsu HH, Hsieh MS, et al. Propensity-matched analysis comparing survival after sublobar resection and lobectomy for ct1n0 lung adenocarcinoma. Ann Surg Oncol, 2019, 27(3): 703-715.
7. Zhu E, Xie H, Dai C, et al. Intraoperatively measured tumor size and frozen section results should be considered jointly to predict the final pathology for lung adenocarcinoma. Mod Pathol, 2018, 31(9): 1391-1399.
8. 朱泳樵, 黄佳, 林皓, 等. 机器人辅助下胸腔镜手术(RATS)与传统胸腔镜手术(VATS)术后患者疼痛情况的比较研究. 中国胸心血管外科临床杂志, 2015, 22(12): 1095-1099.
9. Fox JP, Vashi AA, Ross JS, et al. Hospital-based, acute care after ambulatory surgery center discharge. Surgery, 2014, 155(5): 743-753.
10. 中国日间手术合作联盟. 直肠肛门日间手术临床实践指南(2019 版). 中国普通外科杂志, 2019, 28(11): 1322-1355.
11. 石天晓, 顾潇怡, 于海峰, 等. 国内日间手术实践成效与推广建议. 现代医院管理, 2017, 15(6): 46-48.
12. 嵇武, 刘亚萍, 戴玮. 我国日间手术开展现状与前景展望. 中国实用外科杂志, 2020, 40(2): 199-202.
13. Xie D, Wu J, Hu X, et al. Uniportal versus multiportal video-assisted thoracoscopic surgery does not compromise the outcome of segmentectomy. Eur J Cardio-thorac Surg, 2020: ezaa372.
14. Song C, Shargall Y, Li H, et al. Prevalence of venous thromboembolism after lung surgery in China: a single-centre, prospective cohort study involving patients undergoing lung resections without perioperative venous thromboembolism prophylaxis. Eur J Cardio-thorac Surg, 2019, 55(3): 455-460.
15. 田博, 宋春凤, 李辉, 等. Caprini 和 Rogers 风险评估模型联合使用可以提高胸外科术后患者筛选静脉血栓栓塞症的准确性. 中华胸部外科电子杂志, 2017, 4(3): 186-189.
16. Gould MK, Garcia DA, Wren SM, et al. Prevention of VTE in nonorthopedic surgical patients: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest, 2012, 141(2 Suppl): e227S-e277S.
17. Bahl V, Hu HM, Henke PK, et al. A validation study of a retrospective venous thromboembolism risk scoring method. Ann Surg, 2010, 251(2): 344-350.
18. Pannucci CJ, Bailey SH, Dreszer G, et al. Validation of the caprini risk assessment model in plastic and reconstructive surgery patients. J Am Coll Sur, 2011, 212(1): 105-112.
19. 李辉, 姜格宁, 中国胸外科静脉血栓栓塞症研究协作组. 胸部恶性肿瘤围术期静脉血栓栓塞症预防中国专家共识(2018 版). 中国肺癌杂志, 2018, 21(10): 739-752.
20. 李玉萍, 谢冬, 杨健, 等. 肺部磨玻璃结节术后急性肺动脉栓塞的防治策略. 中国胸心血管外科临床杂志, 2020, 27(4): 465-470.
21. Farge D, Bounameaux H, Brenner B, et al. International clinical practice guidelines including guidance for direct oral anticoagulants in the treatment and prophylaxis of venous thromboembolism in patients with cancer. The Lancet Oncol, 2016, 17(10): e452-e466.
22. 车国卫. 加速康复外科: 肺癌手术日间化现状与策略. 中国肺癌杂志, 2020, 23(1): 1-4.
23. Xie D, Wang H, Fei K, et al. Single-port video-assisted thoracic surgery in 1063 cases: a single-institution experiencedagger. Eur J Cardio-thorac Sur, 2016, 49(Suppl 1): i31-i36.
24. Meltzer MI. Introduction to health economics for physicians. Lancet, 2001, 358(9286): 993-998.
25. 沈诚, 常帅, 周坤, 等. 加速康复外科和日间手术模式在胸外科中的应用现状及发展前景. 中国肺癌杂志, 2020, 23(9): 800-805.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Latest ArticlesThe management of day surgery in minimally invasive surgery for 517 patients with early-stage lung cancer by enhanced recovery after surgery

Abstract Full text Figures/Tables Video References Cited by

Format

Content