Dong Yingxian, Shen Cheng, Wang Yan, Zhou Kun, Li Jue, Chang Shuai, Ma Hongsheng, Che Guowei
Department of Thoracic Surgery, West-China Hospital, Sichuan University, Chengdu, China.
Day Surgery Center, West China Hospital, Sichuan University, Chengdu, China.
Front Surg. 2021 Nov 17;8:779889. doi: 10.3389/fsurg.2021.779889. eCollection 2021.
This study was undertaken to evaluate how safe and viable the use of video-assisted thoracoscopic day surgery (VATDS) is for individuals diagnosed with early-stage non-small cell lung cancer (NSCLC). Data obtained from the selected patients with NSCLC who underwent video-assisted thoracoscopic surgery (VATS) in the same medical group were analyzed and a single-center, propensity-matched cohort study was performed. In total, 353 individuals were included after propensity score matching (PSM) with 136 individuals in the day surgery group (DSG) and 217 individuals in the inpatient surgery group (ISG). The 24-h discharge rate in the DSG was 93.38% (127/136). With respect to the postoperative complications (PPCs), no difference between the two groups was found (DSG vs. ISG: 11.76 vs. 11.52%, = 0.933). In the DSG, a shorter length of stay (LOS) after surgery (1.47 ± 1.09 vs. 2.72 ± 1.28 days, < 0.001) and reduced drainage time (8.45 ± 3.35 vs. 24.11 ± 5.23 h, < 0.001) were found, while the drainage volume per hour (mL/h) was not notably divergent between the relevant groups ( = 0.312). No difference was observed in the cost of equipment and materials between the two groups ( = 0.333). However, the average hospital cost and drug cost of the DSG were significantly lower than those of the ISG ( < 0.001). The study indicated that the implementation of VATDS showed no difference in PPCs, but resulted in shorter in-hospital stays, shorter drainage times, and lower hospital costs than inpatient surgery. These results indicate the safety and feasibility of VATDS for a group of highly selected patients with early-stage NSCLC.
本研究旨在评估电视辅助胸腔镜日间手术（VATDS）用于诊断为早期非小细胞肺癌（NSCLC）患者的安全性和可行性。对同一医疗组中接受电视辅助胸腔镜手术（VATS）的选定NSCLC患者的数据进行分析，并开展了一项单中心、倾向评分匹配队列研究。倾向评分匹配（PSM）后共纳入353例患者，其中日间手术组（DSG）136例，住院手术组（ISG）217例。DSG的24小时出院率为93.38%（127/136）。关于术后并发症（PPCs），两组之间未发现差异（DSG vs. ISG：11.76% vs. 11.52%，P = 0.933）。在DSG中，术后住院时间较短（1.47±1.09天 vs. 2.72±1.28天，P<0.001），引流时间缩短（8.45±3.35小时 vs. 24.11±5.23小时，P<0.001），而相关组之间每小时引流量（mL/h）无明显差异（P = 0.312）。两组之间设备和材料成本无差异（P = 0.333）。然而，DSG的平均住院费用和药物费用显著低于ISG（P<0.001）。该研究表明，VATDS的实施在PPCs方面无差异，但与住院手术相比，住院时间更短、引流时间更短且住院费用更低。这些结果表明VATDS对于一组高度选定的早期NSCLC患者具有安全性和可行性。
