Early recovery and pain management for patients undergoing robotic-assisted thoracic surgery for lung cancer in enhanced recovery after surgery protocol: a pilot study.

To assess early postoperative recovery outcomes and identify risk factors associated with recovery in patients undergoing robotic-assisted thoracic surgery (RATS) within an enhanced recovery after surgery (ERAS) protocol, we conducted a pilot prospective single-center cohort including 82 patients who underwent lung resection by RATS in ERAS protocol. The primary outcome was the total QoR-40 (Quality of Recovery-40) score at 24 h postoperatively. We also explored the QoR-40 pain score at 24 h, in-hospital pain progression over 48 h assessed by numerical pain scale (NPS), morphine consumption, respiratory complications, and residual pain at 3 weeks. Multiple linear or logistic regressions were estimated to determine the related risk factors. The median total QoR-40 score at 24 h was 166 [IQR: 154; 174]. The median QoR-40 pain score at 24 h was 28 [IQR: 24; 30]. The median in-hospital pain (NPS) over the first 48 h was 2 [IQR: 2; 3] and increased by 0.005 points per hour [95% CI -0.007; 0.017]. Female gender was identified as the main association for both QoR-40 recovery score at 24 h [-12.0 points (95% CI -19.8; -4.3)] and QoR-40 pain score at 24 h [-2.3 points (95% CI -4.5; -0.2)]. Residual pain at 3 weeks was present in 20% of patients. The quality of early postoperative recovery in patients undergoing RATS for lung cancer within an ERAS protocol was satisfactory. These findings support broader ERAS implementation to optimize perioperative outcomes and individualize postoperative care in robotic-assisted thoracic surgery.