<p>Successful postoperative recovery management after thoracoscopic lobectomy and segmentectomy using an ERAS-based protocol of immediate ice cream intake and early ambulation: a 3-year study</p>

Abstract

Background: Enhanced recovery after surgery (ERAS) protocols are well known for reducing post-operative complications, facilitating early recovery and reducing hospitalization. In this study, we developed ERAS protocols involving immediate ice cream intake for checking postoperative chylothorax and subsequent early ambulation in order to investigate whether these methods have postoperative benefits. Methods: We retrospectively evaluated 500 patients who underwent thoracoscopic segmentectomy and/or lobectomy (TSL) between January 2014 and September 2017. The patients were divided into two groups: 271 patients for Phase I and 229 for Phase II. Ice cream intake commenced during Phase I. Phase I patients were made to walk on the following day, whereas Phase II ambulate within 4 hrs after immediate ice-cream intake. Results: The mean ice cream intake was significantly higher in Phase II than in Phase I (81.6% vs 56.1%). In Phase II, 91.2% and 94.0% were able to ambulate within 4 and 6 hrs, respectively. Minor postoperative complications (Clavien–Dindo I–II classification) were lower in Phase II (3.1%) than in Phase I (10.4%); however, we found no statistical significance ( p =0.08). Multivariate analysis showed that ice cream intake and removal of chest drainage tube within 4–6 hrs significantly contributed to the reduction of hospitalization to ≤3 postoperative days ( p =0.03 and p <0.01). Conclusions: The results of this study suggested that our ERAS protocol represented by immediate ice cream intake, and early ambulation is feasible and can help in reducing postoperative complications, chest drainage duration, and hospitalization after TSL.

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

“…Analgesia by means of other techniques such as transcutaneous electrical nerve stimulation (TENS) or serratus anterior plane (SAP) block may be used as a technical adjunct to control severe pain (87)(88)(89)(90). Furthermore, pain can be alleviated by early removal of chest drain (91).…”

Safety and Efficacy of Enhanced Recovery After Surgery in Patients Undergoing Minimally Invasive Pneumonectomy: A Systematic Review and Meta-Analysis

“…Khandhar et al[16] designed an ERAS program for VATS lobectomy, requiring a 250-ft walk within an hour after chest tube removal, and found the median LOS was one day shorter in ERAS patients versus non-ERAS controls. Similarly, Kuroda et al [41] proved that chest tube removal and early activity at 4-6 hours post-operation lead to earlier hospital discharge versus conventional care (the reduction of hospitalization to ≤ 3 postoperative days). All these studies applied early mobilization, an important ERAS element, which is assumed to be a signi cant contributor to a shorter LOS.…”

Microbial Risk Assessment of Industrial Ice Cream Marketed in Italy

“…Major concerns are associated with vulnerable people such as YOPI, for whom even low loads of pathogens can result in serious outcomes [19]. In this regard, we underline that ice cream is widely consumed by children and also recommended in postoperative recovery diets in patients undergoing various types of surgeries [32,33].…”