Clinical guidelines on perioperative management strategies for enhanced recovery after lung surgery

Gao, Shugeng; Barello, Serena; Chen, Liang; Chen, Chun; Che, Guowei; Cai, Kaican; Crisci, Roberto; D’Andrilli, Antonio; Droghetti, Andrea; Fu, Xiangning; Ferrari, Paolo Albino; Fernando, Hiran C.; Graffigna, Guendalina; Huang, Yunchao; Hu, Jian; Jiao, Wenjie; Jiang, Gening; Li, Xiaofei; Li, Hui; Li, Shanqing; Liu, Lunxu; Ma, Haitao; Ma, Dongchun; Martínez, Guillermo; Maurizi, Giulio; Phan, Kevin; Qiao, Kun; Refai, Majed; Rendina, Erino Angelo; Shao, Guoguang; Shen, Jianfei; Tian, Hui; Voltolini, Luca; Vannucci, Jacopo; Vanni, Camilla; Wu, Qingchen; Xu, Shidong; Yu, Fenglei; Zhao, Song; Zhang, Peng; Zhi, Xiao; Zhu, Chengchu; Ng, Calvin S. H.; Sihoe, Alan D.L.; Ho, Anthony M.‐H.

doi:10.21037/tlcr.2019.12.25

Cited by 27 publications

(35 citation statements)

References 94 publications

(89 reference statements)

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“…During severe hypoxemia, continuous positive airway pressure was applied to the non-dependent lung [ 13 ]. The end-tidal CO 2 concentration was maintained between 35 and 40 cmH 2 O, and the following lung-protective ventilation strategies were implemented [ 2 , 13 ]: low tidal volume (4–6 ml/kg), positive end-expiratory pressure, and lung recruitment. Flexible fiber-optic bronchoscopy (ED 3.1 mm, Olympus Optical, Japan) was used at least twice to confirm correct placement of the DLT immediately following intubation and repositioning.…”

Section: Methodsmentioning

confidence: 99%

“…It contained fentanyl 30 µg/kg and ramosetron 0.6 mg in normal saline with a total volume of 100 ml, and it was delivered at 1 ml/h as a background infusion with a 1 ml bolus dose (10 min lock-out time). To reduce opioid consumption, 0.5% ropivacaine was infused at 5 ml/h through a pain buster (Pain Relief System, Halyard Health, Inc., USA) intercostally before the end of surgery [ 2 ].…”

Section: Methodsmentioning

confidence: 99%

“…The primary goal of enhanced recovery after surgery (ERAS) in lung surgery is to optimize perioperative and intraoperative management to reduce postoperative complications and decrease the length of hospital stay [ 1 , 2 ]. Particularly, in the field of anesthesia management, neuromuscular blockade (NMB) and its reversal are important because deep NMB is necessary during thoracoscopic lung surgery to secure a good field of view and operating space for the surgeon.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Comparison of postoperative pulmonary complications between sugammadex and neostigmine in lung cancer patients undergoing video-assisted thoracoscopic lobectomy: a prospective double-blinded randomized trial

Lee

Jeong

et al. 2021

Anesth Pain Med

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Background: Reversal of neuromuscular blockade (NMB) at the end of surgery is important for reducing postoperative residual NMB; this is associated with an increased risk of postoperative pulmonary complications (PPCs). Moreover, PPCs are associated with poor prognosis after video-assisted thoracoscopic surgery (VATS) for lobectomy. We compared the effects of two reversal agents, sugammadex and neostigmine, on the incidence of PPCs and duration of hospital stay in patients undergoing VATS lobectomy.Methods: After VATS lobectomy was completed under neuromuscular monitoring, the sugammadex group (n = 46) received sugammadex 2 mg/kg, while the neostigmine group (n = 47) received neostigmine 0.05 mg/kg with atropine 0.02 mg/kg after at least the third twitch in response to the train of four stimulation. The primary outcome was incidence of PPCs. The secondary outcomes were duration of hospital stay and intensive care unit (ICU) admission. Results: There was no significant difference in the incidence of PPCs for both the sugammadex and neostigmine groups (32.6% and 40.4%, respectively; risk difference = 0.08; 95% confidence interval = [−0.12, 0.27]; P = 0.434). The lengths of hospital (P = 0.431) and ICU (P = 0.964) stays were not significantly different between the two groups.Conclusions: The clinical use of sugammadex and neostigmine in NMB reversal for patients undergoing VATS lobectomy was not significantly different in the incidence of PPCs and duration of hospital and ICU stay.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Comparison of postoperative pulmonary complications between sugammadex and neostigmine in lung cancer patients undergoing video-assisted thoracoscopic lobectomy: a prospective double-blinded randomized trial

Lee

Jeong

et al. 2021

Anesth Pain Med

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“…According to the literature described above, the Patient Health Engagement model refers to the patient's psychological readiness to play an active role in his/her own healthcare journey as an autonomous actor taking increased responsibility for decision-making regarding his or her health. [28]. This model is rooted in the concept of patients' autonomy, and thus it values the importance of supporting patients' interest in and desire to participate in healthcare decisions.…”

Section: Theory and Hypothesesmentioning

confidence: 99%

The Mediating Role of the Patient Health Engagement Model on the Relationship Between Patient Perceived Autonomy Supportive Healthcare Climate and Health Literacy Skills

Barello

Palamenghi

Graffigna

2020

IJERPH

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Individuals with low health literacy (HL) are known to have poorer health outcomes and to have higher mortality rates compared to individuals with higher HL; hence, the improvement of HL is a key outcome in modern healthcare systems. Healthcare providers are therefore asked to support patients in becoming more and more engaged in their healthcare, thus augmenting their literacy skills. Our main hypothesis is that the well-known relationship between patients' perceived autonomy supportive healthcare climate and HL skills is mediated by the Patient Health Engagement Model (PHE-model) which describes the patients' progressive maturation of a psychological readiness to become active players in their healthcare. The purpose of this study was to formulate a hypothetical structural equation model (SEM) linking an autonomy-supportive healthcare climate to PHE-model and HL. A cross-sectional survey design was employed involving 1007 Italian chronic patients. The hypothetical model was tested using SEM to verify the hypothesized mediation of the PHE-model between autonomy-supportive healthcare climate and HL. Results show that the theoretical model has a good fit indexes and that PHE-model fully mediates the relationship between autonomy-supportive healthcare climate and HL. This finding suggests healthcare systems to implement a new paradigm where patients are supported to play an autonomous role in their own healthcare.

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“…Modern approaches such as uniportal VATS have become established which promise even less morbidity than ever before (25,54). These techniques can be coupled with modern strategies of enhanced recovery after surgery (ERAS) to further improve patient outcomes post-operative (55)(56)(57). Altogether, these advances mean that surgery can be performed with morbidity rates that are significantly lower than those considered by the guidelines, and which are not much more than what can be expected from non-surgical biopsy (58).…”

Section: "Why Are We Avoiding Surgery For Diagnosis?"mentioning

confidence: 99%

Should sublobar resection be offered for screening-detected lung nodules?

Sihoe¹

2021

Transl Lung Cancer Res

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The increasing use of low-dose CT for screening for lung cancer will inevitably identify many small, asymptomatic lung nodules and ground-glass opacities (GGOs). Current guidelines for the management of screening-detected lesions tend to advise a conservative approach based on serial imaging and intervention only if 'suspicious' features emerge. However, more recent developments in thoracic surgery and in the understanding of the screening-detected lesions themselves prompt some pertinent questions over this conservatism. Is CT surveillance sufficiently reliable to exclude malignancy? Is it really necessary to hold back on operative biopsy and resection given modern surgical safety and efficacy? Is the option for early surgical therapy a viable one-especially with the availability of sublobar resection today? Modern data suggests that the risk of inaction for some screening-detected lesions may be higher than expected, whereas the potential harm of surgical intervention may be substantially reduced by sublobar resection and the latest minimally invasive surgical techniques. A more pro-active approach towards offering surgery for screeningdetected lesions should now be considered.

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Clinical guidelines on perioperative management strategies for enhanced recovery after lung surgery

Cited by 27 publications

References 94 publications

Comparison of postoperative pulmonary complications between sugammadex and neostigmine in lung cancer patients undergoing video-assisted thoracoscopic lobectomy: a prospective double-blinded randomized trial

Comparison of postoperative pulmonary complications between sugammadex and neostigmine in lung cancer patients undergoing video-assisted thoracoscopic lobectomy: a prospective double-blinded randomized trial

The Mediating Role of the Patient Health Engagement Model on the Relationship Between Patient Perceived Autonomy Supportive Healthcare Climate and Health Literacy Skills

Should sublobar resection be offered for screening-detected lung nodules?

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