Tat Bang Ho, Thanh Vy Tran, Tap Nguyen Van
Department of Thoracic and Vascular, University Medical Center Ho Chi Minh City, Ho Chi Minh City, VNM.
Department of Health Organization and Management, University Medical Center Ho Chi Minh City, Ho Chi Minh City, VNM.
Cureus. 2024 Apr 8;16(4):e57870. doi: 10.7759/cureus.57870. eCollection 2024 Apr.
Lobectomy is a standard surgical method in the treatment of early stages of non-small cell lung cancer (NSCLC). The enhanced recovery after surgery (ERAS) program aims to reduce the postoperative length of hospital stay (PLOS) in major surgeries. This study evaluated the impact of the ERAS program on PLOS and identified related factors in patients undergoing lobectomy for NSCLC.
This prospective observational study was conducted at the University Medical Center Ho Chi Minh City, Vietnam, from February 2022 to December 2023. We included patients diagnosed with NSCLC scheduled for lobectomy. The ERAS protocol was applied according to guidelines from the ERAS Society and the French Society of Anaesthesia and Intensive Care Medicine. We collected data on patient demographics, surgical details, adherence to the ERAS protocol, and postoperative outcomes, including the PLOS.
Among the 98 patients enrolled, the median PLOS after ERAS intervention was 4.1 days (interquartile range: 3.7 to 5.2 days). Adherence to ERAS protocols significantly correlated with reduced PLOS (p<0.001). Notably, smoking status was identified as a related factor of PLOS (p=0.002). Complications (p<0.001), surgical method (p=0.007), operation time (p<0.001), duration of postanesthesia care unit (p=0.006), duration of thoracic drainage (p<0.001), and urinary catheter retention time (p=0.023) were also associated with PLOS variations.
Implementing the ERAS program in patients undergoing lobectomy for NSCLC at our center reduced PLOS and highlighted the importance of protocol adherence for optimizing surgical outcomes. These findings supported the broader adoption of ERAS protocols in thoracic surgery to enhance patient recovery. Future research should focus on multi-center studies to generalize these results and further dissect the impact of individual ERAS components.
肺叶切除术是治疗非小细胞肺癌（NSCLC）早期阶段的标准手术方法。术后加速康复（ERAS）计划旨在缩短大手术的术后住院时间（PLOS）。本研究评估了ERAS计划对PLOS的影响，并确定了接受NSCLC肺叶切除术患者的相关因素。
本前瞻性观察性研究于2022年2月至2023年12月在越南胡志明市大学医学中心进行。我们纳入了计划接受肺叶切除术的NSCLC诊断患者。根据ERAS学会和法国麻醉与重症医学学会的指南应用ERAS方案。我们收集了患者人口统计学、手术细节、对ERAS方案的依从性以及术后结果的数据，包括PLOS。
在纳入的98例患者中，ERAS干预后的PLOS中位数为4.1天（四分位间距：3.7至5.2天）。对ERAS方案的依从性与PLOS缩短显著相关（p<0.001）。值得注意的是，吸烟状况被确定为PLOS的相关因素（p=0.002）。并发症（p<0.001）、手术方法（p=0.007）、手术时间（p<0.001）、麻醉后监护病房时长（p=0.006）、胸腔引流时长（p<0.001）和导尿管留置时间（p=0.023）也与PLOS变化相关。
在我们中心对接受NSCLC肺叶切除术的患者实施ERAS计划可缩短PLOS，并强调了遵循方案对优化手术结果的重要性。这些发现支持在胸外科更广泛地采用ERAS方案以促进患者康复。未来的研究应集中在多中心研究上，以推广这些结果并进一步剖析各个ERAS组成部分的影响。
