Enhanced recovery after surgery using uniportal video‐assisted thoracic surgery for lung cancer: A preliminary study

Abstract

BackgroundThis study investigated the clinical efficiency of enhanced recovery after surgery (ERAS) using uniportal video‐assisted thoracoscopic surgery for lung cancer.MethodsThe clinical data of 83 patients with early‐stage non‐small cell lung cancer (NSCLC) at the First Affiliated Hospital of Soochow University from January 2016 to February 2017 were retrospectively analyzed. ERAS was applied to 38 patients (ERAS group), while 45 patients received conventional surgical treatment (control group). The operative duration, number of lymph nodes retrieved, blood loss, visual analogue scale (VAS), postoperative duration of chest tube placement, length of hospital stay, and postoperative complications were compared between the groups.ResultsSurgeries were conducted successfully in all patients, and no mortality occurred during the perioperative period. The ERAS group had better VAS on the third postoperative day, shorter chest tube duration, and shorter length of hospital stay (P < 0.05). No differences between the groups in terms of operative duration, number of lymph nodes retrieved, blood loss, VAS on the first postoperative day, or complication rate were found (P > 0.05).Conclusions ERAS using uniportal video‐assisted thoracoscopic surgery for NSCLC patients is safe and practicable, and could also reduce the length of hospital stay.

Tubeless minimally invasive treatment: taking a new step in enhanced recovery after surgery (ERAS)

“…In the study reported in 2018, patients in the ERAS group had better results on the third day after surgery than on the first day in the visual analog scale (VAS), whilst the length of hospital stay in the ERAS group was shorter than in the control group. The results are probably due to a beneficial aspect of the reduction in trauma caused by uniportal VATS (Table ).…”

Anaesthesia management for bronchoscopic and surgical lung volume reduction

“…Lung protective ventilation has become an integral part of protocols to prevent pulmonary complications like pneumonia or accelerate the recovery time [e.g., enhanced recovery after surgery (ERAS)], which is both also, wanted in LVR (23)(24)(25).…”

“…Strong evidence exists for a normovolemic fluid regimen in thoracic surgery ( Table 2). Balanced crystalloids are recommended, saline solutions should be avoided and colloids should only be used as a substitute for blood loss (23,25).…”

Body surface area as a novel risk factor for chylothorax complicating video‐assisted thoracoscopic surgery lobectomy for non‐small cell lung cancer

“…Nowadays, radical surgery is regarded not only as the optimal therapeutic option for early‐stage non‐small‐cell lung cancer (NSCLC), but also as the cornerstone of multidisciplinary treatments for more advanced NSCLC . Since the 1990s, single lobectomy via video‐assisted thoracoscopic surgery (VATS), a minimally invasive procedure providing access to the chest cavity, has been developed as a modern surgical modality for operable NSCLC, offering more advantages than conventional thoracotomy in terms of the cosmetic wounds, pain and stress control, preservation of pulmonary function, and enhanced recovery . Despite advances in surgical techniques and perioperative care, however, the morbidity rate after VATS lobectomy remains 26.2–36.3% …”

“…[4][5][6][7] Since the 1990s, single lobectomy via video-assisted thoracoscopic surgery (VATS), a minimally invasive procedure providing access to the chest cavity, has been developed as a modern surgical modality for operable NSCLC, offering more advantages than conventional thoracotomy in terms of the cosmetic wounds, pain and stress control, preservation of pulmonary function, and enhanced recovery. 6,[8][9][10][11][12] Despite advances in surgical techniques and perioperative care, however, the morbidity rate after VATS lobectomy remains 26.2-36.3%. 6,[11][12][13] As a fatal complication following elective pulmonary resection, the postoperative management of chylothorax (which is generally secondary to thoracic duct injury, with its tributaries), poses a great challenge to thoracic surgeons because of the uncontrollable accumulation of fatty lymphatic fluid in the pleural space and subsequently high mortality, up to 30%.…”