Fast-track rehabilitation after anatomical lung resection: prospective single-center non-randomized trial

Abstract

To present the results of fast track rehabilitation after anatomical lung resection. Single-center prospective non-randomized trial has included patients for the period December 2014 - December 2016. Conventional protocol was applied in 124 patients, 58 patients after atypical lung resections or pneumonectomy were excluded from the study. Thus, there were 66 patients aged 61 (51; 67) years. Men/women ratio was 37:29. Lobectomy (n=55) and segmentectomy (n=11) were performed for lung cancer, metastatic injury and various inflammatory diseases in 53 (80.3%), 8 (12.1%) and 5 (7.6 %) cases, respectively. ASA risk score was II (16), III (46), IV (4). Video-assisted/open procedures ratio was 42 (63.6%) / 24 (36.4%). 30-day postoperative morbidity was 7.6% (5 out of 66 patients, 95% CI 3.3- 16.5). Pleural drainage tube was removed within the 1st postoperative day in 49 (74.2%) out of 66 patients. Prolonged insufficient aerostasis was observed in 3 patients followed by effective conservative treatment. Overall mortality was 3% (n=2, 95% CI 0.8- 10.4) due to pulmonary embolism and sudden cardiac death. Median of postoperative hospital-stay was 7 (6; 9) days without significant differences between groups of lobectomy and segmentectomy (p>0.05). Fast track rehabilitation protocol in thoracic surgery is safe and effective. Further studies are needed to justify early rehabilitation in high risk patients.