EP1.18-24 Novel Technique - Mini Port Thoracoscopic Approach and Enhanced Recovery After Surgery for Treatment of Lung Cancer

Abstract

In the last two decades, thoracic minimal invasive surgical approaches gain in the treatment of lung cancer. Mainly, because they are less invasive and they provide shortened hospital stay. With new anesthesia protocols which are incoporated in Enhanced Recovery After Surgery (ERAS) protocol, they are one of the most important points in the treatment of lung cancer. New mini video-assisted thoracoscopic surgical approach and enhanced recovery after surgery approach are safe for the patients and decreases hospital stay of the patients. In our study were inroled 100 patients who undergone surgery for lung cancer. All of them were treated with a new minimal invasive approach - mini Video Assisted Thoracic Surgery (VATS). The approach is less traumatic of all other previous described and used minimal invasive thoracoscopic procedures because it consists of only two small ports (mini ports), 1cm each. One port we use for the camera and the other port for applying the instruments in the thoracic cavity. We didn't use additional ports. Also, this minimal invasive approach is more cosmetic than all other previosly used minimal invasive thoracic approaches which is important for most of the patients. All of the patients undergone general anesthesia with endotracheal double-lumen tube. They all had lobectomy (or segmentectomy) with locoregional lymphadenectomy. Twenty to fifty minutes after extubation all of the patients were doing some easy exercises in the operating room (OR) and were walking from the OR to their room in the Department. Because of the new minimal invasive surgical approach, less-invasive surgical treatment and anesthesiology protocol incorporated in ERAS protocol, none of the patients who undergone this type of treatment had complications in the postoperative period. Also, all of the patients were discharged on the 2nd (some of them 3rd) postoperative day. Their recovery was faster, they had shorter hospital stay, without any complications, and they had less needs for analgesics in the postoperative period. Our new multimodal approach (anesthesiological and surgical) showed that described less invasive surgical approach as well as treatment, and adequate anesthesiologic technique incorporated in ERAS protocol are the key for adequate treatment as well as early recovery of the patients treated for lung cancer. Also, postoperative complications and hospital stay were decreased a lot. Also, the patients were more satisfied in the postoperative period because of their extremely early recovery after surgery as well as shortened hospital stay.