One-day admission for major lung resections in septuagenarians and octogenarians: a comparative study with a younger cohort

Tovar, Eduardo A.

doi:10.1016/s1010-7940(01)00835-1

Cited by 43 publications

(21 citation statements)

References 14 publications

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“…Their criteria for avoiding chest tube placement were: absence of air leaks intraoperatively, absence of bullous or emphysematous changes, absence of severe pleural adhesions and absence of prolonged pleural effusion. They concluded that such practice could be safe without increase in postoperative morbidity if patients were selected carefully [18]. Our results were consistent with this author's findings and were not influenced by operating using awake anaesthesia.…”

Section: Discussionsupporting

confidence: 91%

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Awake anaesthesia for major thoracic surgical procedures: an observational study

Al-Abdullatief

Wahood

Al-Shirawi

et al. 2007

European Journal of Cardio-Thoracic Surgery

113

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We conclude that major thoracic procedure can be safely performed under awake anaesthesia. The technique avoids general anaesthesia and endotracheal intubation, reduces postoperative hospital stay and minimizes intensive care unit admission. This study strongly suggests awake anaesthesia can improve outcomes and reduce cost. A proper multi-center trial to further evaluate this technique is needed.

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Section: Discussionsupporting

confidence: 91%

“…This resulted in improved patient satisfaction and hospital resource utilization. Other studies have shown that 1-day admission after major lung resection can be a safe practice with minimal morbidity [17][18][19]. Only five patients in our study required ICU admission.…”

Section: Discussionmentioning

confidence: 63%

Awake anaesthesia for major thoracic surgical procedures: an observational study

Al-Abdullatief

Wahood

Al-Shirawi

et al. 2007

European Journal of Cardio-Thoracic Surgery

113

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“…Some of these protocols have proposed discontinuing the chest tube on post-operative day (POD) 2 or 3 as a method to reduce hospitalization (7). Other studies have advocated for discharge on the first POD after lung resection, but the safety of this approach is unknown (8,9). Despite anecdotal support for ED, this approach has not been studied.…”

Section: Introductionmentioning

confidence: 99%

Early discharge after lung resection is safe: 10-year experience

Towe¹,

Khil²,

Ho³

et al. 2018

J. Thorac. Dis

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Background: The average hospitalization after lung resection is 6 days, but some patients are discharged early in the post-operative period. The patient factors associated with early discharge (ED) and the safety of this approach are unknown. We hypothesized that specific patient populations are associated with ED, and that complications in this practice are low. Methods: A prospective database of lung resections performed at an academic medical center between Jan 1, 2007 and Jan 1, 2017 was queried. Demographic and outcome variables were assessed using standard techniques. ED was defined as the length of stay (LOS) for the quintile with the lowest LOS for patients with anatomic resection (AR) or patients with wedge resection (WR). We then compared clinical factors between patients with ED to those patients discharged by day 7, to determine factors associated with ED (relative to "average" discharge). Results: During the study period, there were 922 AR and 1,150 WR performed. A total of 448 (39.0%) patients had WRED and 211 patients (22.9%) had ARED. The rate of WRED varied by surgeon, but ARED did not. ARED and WRED patients was associated with several factors, including younger age, better lung function, and were less likely to have elevated American Society of Anesthesiologist (ASA) class. Multivariable analysis suggested that patient factors and primary surgeon influence ED. WRED was associated with 30-day mortality of 0.22% vs. 1.14% for longer LOS (P=0.08). After AR, there were no post-operative deaths within 30 days among 211 patients discharged on postoperative day 1 or 2 [(vs. 2/541, 0.4%, P=0.376) with longer LOS, P=0.048]. Conclusions: ED after lung resection is multifactorial but is safe among selected patients. Age, lung function, procedure duration, and surgeon all influence ED. Complications after ED were rare. Individual surgeon comfort with ED likely impacts LOS, and education or enhanced recovery protocols may help overcome this barrier. Standardized pathways would likely help identify low-risk patients for expeditious discharge.

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“…Video-assisted thoracoscopic surgery (VATS) is a minimally invasive surgical technique used for a variety of diagnostic and therapeutic procedures including lung biopsy, wedge resection, lobectomy, and mediastinal lymph node biopsy as well as for major surgical procedures like pneumonectomy. [ 1 2 ] This technique is becoming increasingly popular because of a low complications rate, reduced surgical morbidity and mortality, less pain, reduced length of stay in hospital as well as reduced cost. [ 1 ]…”

Section: Introductionmentioning

confidence: 99%

Role of intercostal nerve block in reducing postoperative pain following video-assisted thoracoscopy: A randomized controlled trial

2017

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Background:The main advantages of video assisted thoracoscopic surgery (VATS) include less post-operative pain, rapid recovery, less postoperative complications, shorter hospital stay and early discharge. Although pain intensity is less as compared to conventional thoracotomy but still patients experience upto moderate pain postoperatively. The objective of this study was to assess the efficacy and morphine sparing effect of intercostal nerve block in alleviating immediate post-operative pain in patients undergoing VATS.Materials and Methods:Sixty ASA I-III patients, aged between 16 to 60 years, undergoing mediastinal lymph node biopsy through VATS under general anaesthesia were randomly divided into two groups. The intercostal nerve block (ICNB group) received the block along with patient control intravenous analgesia (PCIA) with morphine, while control group received only PCIA with morphine for post-operative analgesia. Patients were followed for twenty four hours post operatively for intervention of post-operative pain in the recovery room and ward.Results:The pain was assessed using visual analogue scale (VAS) at 1, 6, 12 and 24 hours. There was a significant decrease in pain score and morphine consumption in ICNB group as compared to control group in first 6 hours postoperatively. There was no significant difference in pain scores and morphine consumption between the two groups after 6 hours.Conclusion:Patients receiving intercostal nerve block have better pain control and less morphine consumption as compared to those patients who did not receive intercostal nerve block in early (6 hours) post-operative period.

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One-day admission for major lung resections in septuagenarians and octogenarians: a comparative study with a younger cohort

Cited by 43 publications

References 14 publications

Awake anaesthesia for major thoracic surgical procedures: an observational study

Awake anaesthesia for major thoracic surgical procedures: an observational study

Early discharge after lung resection is safe: 10-year experience

Role of intercostal nerve block in reducing postoperative pain following video-assisted thoracoscopy: A randomized controlled trial

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