Enhanced recovery programmes in thoracic surgery: how does the future look?

Giménez-Milà, Marc; Martínez, Guillermo; George, Sandhya

doi:10.1177/0141076817753625

Cited by 4 publications

(4 citation statements)

References 22 publications

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“…This is discussed more fully by Giminez-Mila. 14 The shorter discharge and other benefits arising from being able to mobilise the patient on the day of surgery and changing their expectations to one of very early discharge should not be underestimated. Part of this has come about from the availability of ambulatory chest drains systems which deliver controlled suction and being able to safely discharge patients with their chest drain in place.…”

Section: The Impact Of Enhanced Recoverymentioning

confidence: 99%

“…Anaesthetists are attempting to minimise the impact of their anaesthetic on patients, to hasten their recovery: with developments such as ‘opioid-free’ anaesthetic and non-intubated thoracic surgery; together with renewed appreciation of the positive benefit peri-operative nerve blocks have. 14 With these advances, patients are routinely being mobilised on the same day as surgery with collaboration of physiotherapists. A small number of patients undergo lobectomy as day-surgery.…”

Section: Thoracic Anaesthesia and Enhanced Recoverymentioning

confidence: 99%

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Thoracic surgery for lung cancer: current practice and future directions

et al. 2019

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Section: The Impact Of Enhanced Recoverymentioning

confidence: 99%

Section: Thoracic Anaesthesia and Enhanced Recoverymentioning

confidence: 99%

Thoracic surgery for lung cancer: current practice and future directions

et al. 2019

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“…Anesthesia and enhanced recovery in subxiphoid video-assisted thoracoscopic surgery of well-developed enhanced recovery programs which further aids the benefit of the SVATS approach (16,17). However, SVATS presents certain perioperative challenges for the thoracic anaesthetic team.…”

Section: Review Articlementioning

confidence: 99%

Anesthesia and enhanced recovery in subxiphoid video-assisted thoracoscopic surgery

Chen

Ali

et al. 2018

J. Thorac. Dis

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Subxiphoid video-assisted thoracoscopic surgery (VATS) is a surgical approach in minimally invasive thoracic surgery that aims to aid enhanced recovery by reducing postoperative pain by avoiding instrumentation of the intercostal spaces. Access through a subxiphoid port presents challenges for both the surgeon and anaesthetist. Particularly for left sided procedures, the heart can be compressed resulting in arrhythmia and haemodynamic compromise. The anaesthetic team play an important role in ensuring the success of subxiphoid VATS procedures. The key is continuous and comprehensive monitoring for circulatory disturbance and arrhythmia intraoperatively. Should arrhythmia develop it is important that it is managed rapidly and effectively in such a manner to minimize haemodynamic disturbance. In this article, important considerations for anaesthesia in subxiphoid VATS procedures is presented and solutions presented.

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“…Alternatively, professional politics might get in the way of providing effective recovery that relies on a multidisciplinary approach in thoracic surgery. 3 Elsewhere, don't allow your regional politics to miss a letter from Wales on medicines identified as low priority for funding, 4 as well as an account of the pioneering work in Glasgow on controlled trials to treat erysipelas and pneumonia. 5 Failing that, you should certainly find out why our politicians might help us by ending a crisis in our necropolises.…”

mentioning

confidence: 99%

Health is politics writ large and small

Abbasi¹

2019

J R Soc Med

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With a current, former and, possibly, future Secretary of State for Health seeking election as leader of the United Kingdom's Conservative Party, the political importance of the role becomes stark. Health ministers want to improve health but they also want to improve their political credentials. Health and politics are interwoven with generally undesirable effects, which is why people promote the idea of an independent NHS, cut free from the political system, free to do what's best for the population's health. In practice, this seems a non-starter. Politicians will always want control of something that matters as much to the electorate as health does. This isn't a problem unique to the UK. Nearly every country is caught between the short-term ambitions of politicians and the longer-term needs of developing a high-class health service. There are exceptions, of course. Take China, for example, where one party rule allows the government to implement a 10-year plan to transform the country's health service. When that plan is done, progress and challenges addressed, a new 10-year plan can be introduced, building seamlessly from the previous one. Indeed, that is exactly what is happening in China this year. Now, this isn't a call for the end of democracy but just something to consider when we believe challenges are unsurmountable. For, without doubt, China's problems are greater than our own except that the Chinese system allows a way to cut through them. Assuming a totalitarian system will never find sufficient enthusiasts, what is our solution to the myriad challenges of our health service? How do we find a political solution for health? If we accept that, unlike China, our politics are variable, how do we give our health service enough space to develop and serve in the people's long-term interests? A central debate is the line between public and private provision. The dominant view, and not necessarily the correct one, is that private providers are essential to service delivery. The policy was enshrined in the NHS Plan of 2000 and independent sector treatment centres were commissioned to treat NHS patients from 2003. The thinking was this would

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Enhanced recovery programmes in thoracic surgery: how does the future look?

Cited by 4 publications

References 22 publications

Thoracic surgery for lung cancer: current practice and future directions

Thoracic surgery for lung cancer: current practice and future directions

Anesthesia and enhanced recovery in subxiphoid video-assisted thoracoscopic surgery

Health is politics writ large and small

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