Abstract

BackgroundThe aim of this study is to investigate the effects of fast-track surgery (FTS) on postoperative recovery, hospital stay, total medical costs, and the complications of pneumonectomy in patients with non-small cell lung cancer (NSCLC).MethodsStudies were performed between June 2012 and March 2014 in 17 patients received FTS and 18 patients given conventional management (control) after pneumonectomy in the Department of Thoracic Surgery, the Fourth Affiliated Hospital of Harbin Medical University. Patients were evaluated based on their days to achieve the first postoperative flatus, C-reactive protein (CRP) at postoperative day (POD) 1–7, the length of hospital stay, the medical costs, and postoperative complications.ResultsThe results showed that in the FTS group, latency to the first postoperative flatus (1.5 ± 0.6 versus 3.1 ± 0.8 s in controls, P < 0.0001), CRP (71.36 ± 5.48 versus 80.71 ± 8.32 mg/L in at POD 7, P < 0.0001), the length of hospital stay (18.1 ± 1.4 versus 27.4 ± 6.6 days, P < 0.0001), and the medical costs (29.9 ± 2.7 versus 37.2 ± 3.6 thousand Chinese Yuan, P < 0.0001) were significantly reduced compared to the group receiving conventional management. FTS group also had a relatively lower postoperative complication rate (23.5% of 17 versus 33.3% of 18 in control group) although it was statistically insignificant (P = 0.711).ConclusionsThese results indicate that application of the FTS in NSCLC pneumonectomy efficiently accelerates postoperative recovery, shortens hospital stay, reduces the total medical costs of the patients and thus is more acceptable than conventional management.

Highlights

  • The aim of this study is to investigate the effects of fast-track surgery (FTS) on postoperative recovery, hospital stay, total medical costs, and the complications of pneumonectomy in patients with non-small cell lung cancer (NSCLC)

  • To evaluate the beneficial potential of FTS in pneumonectomy, we compared the outcomes of pneumonectomy in the patients of non-small cell lung cancer (NSCLC) who had been treated with FTS to those who received conservative perioperational preparations

  • Our results indicate that FTS can efficiently accelerate postoperative recovery, shorten hospital stay, and reduce the total medical costs for NSCLC patients

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Summary

Introduction

The aim of this study is to investigate the effects of fast-track surgery (FTS) on postoperative recovery, hospital stay, total medical costs, and the complications of pneumonectomy in patients with non-small cell lung cancer (NSCLC). FTS should benefit patients of pneumonectomy, which remains to be evaluated, when some points of the original fast-track program such as early exercise and epidural analgesia are current standard practice in most of thoracic surgical departments. To evaluate the beneficial potential of FTS in pneumonectomy, we compared the outcomes of pneumonectomy in the patients of non-small cell lung cancer (NSCLC) who had been treated with FTS to those who received conservative perioperational preparations. Our results indicate that FTS can efficiently accelerate postoperative recovery, shorten hospital stay, and reduce the total medical costs for NSCLC patients. This study indicates that FTS remains feasible and useful in the setting of NSCLC pneumonectomy

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