Abstract
BackgroundThe study aimed to evaluate the outcomes following the implementation of enhanced recovery after surgery (ERAS) for patients undergoing lung cancer surgery.MethodA retrospective cohort study involving 1749 patients with lung cancer undergoing pulmonary resection was conducted. The patients were divided into two time period groups for analysis (routine pathway and ERAS pathway). Logistic regression analysis was performed to assess the risks of developing postoperative pulmonary complications.ResultsAmong the 1749 patients, 691 were stratified into the ERAS group, and 1058 in to the routine group. The ERAS group presented with shorter postoperative in-hospital length of stay (LOS) (4.0 vs 6.0, P < 0.001), total LOS (10.0 vs. 13.0 days, P < 0.001), and lower total in-hospital costs (P < 0.001), including material (P < 0.001) and drug expenses (P < 0.001). Furthermore, the ERAS group also presented with a lower occurrence of postoperative pulmonary complications (PPCs) than the routine group (15.2% vs. 19.5%, P = 0.022). Likewise, a significantly lower occurrence of pneumonia (8.4% vs. 14.2%, P < 0.001) and atelectasis (5.9% vs. 9.8%, P = 0.004) was found in the ERAS group. Regarding the binary logistic regression, the ERAS intervention was the sole independent factor for the occurrence of PPCs (OR: 0.601, 95% CI 0.434–0.824, P = 0.002). In addition, age (OR: 1.032, 95% CI 1.018–1.046), COPD (OR: 1.792, 95% CI 1.196–2.686), and FEV1 (OR: 0.205, 95% CI 0.125–0.339) were also independent predictors of PPCs.ConclusionImplementation of an ERAS pathway shows improved postoperative outcomes, including shortened LOS, lower in-hospital costs, and reduced occurrence of PPCs, providing benefits to the postoperative recovery of patients with lung cancer undergoing surgical treatment.
Highlights
The study aimed to evaluate the outcomes following the implementation of enhanced recovery after surgery (ERAS) for patients undergoing lung cancer surgery
The ERAS group presented with shorter postoperative in-hospital length of stay (LOS) (4.0 vs 6.0, P < 0.001), total LOS (10.0 vs. 13.0 days, P < 0.001), and lower total in-hospital costs (P < 0.001), including material (P < 0.001) and drug expenses (P < 0.001)
The ERAS group presented with a lower occurrence of postoperative pulmonary complications (PPCs) than the routine group (15.2% vs. 19.5%, P = 0.022)
Summary
The study aimed to evaluate the outcomes following the implementation of enhanced recovery after surgery (ERAS) for patients undergoing lung cancer surgery. Enhanced recovery after surgery (ERAS), an evidencebased multimodal protocol for perioperative care. ERAS strategies have been considerably developed and enrolled a growing number of elements in all aspects of perioperative care, aiming to largely reduce the stress response to surgery, complications, and the in-hospital length of stay (LOS) after surgery. A series of studies have focused on ERAS strategies for thoracic surgery in the past few years, indicating that ERAS can efficiently minimize the surgical trauma, reduce postoperative complications, improve quality of life before and after surgery, shorten hospital stay and decrease the financial burden of patient [8,9,10,11]. A larger sample size and more diverse regions of study are needed to determine the effectiveness of ERAS strategies
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