建立优化肺叶切除术患者管理的建议，特别是增强手术后恢复（ERAS）。
由法国麻醉和重症监护医学学会的13名专家组成的共识委员会（Soci，t,FranOaised\'anesth,sieetder，动画,SFAR）和法国胸心血管外科学会（Soci，t,法国胸外科和心血管疾病，SFCTCV）召开。正式的利益冲突政策是在这一过程开始时制定的，并在整个过程中得到执行。整个指南过程独立于任何行业资金进行。建议作者遵循建议评估分级的原则，开发和评估（等级）系统，以指导证据质量评估。
定义了五个领域：1）患者路径和患者信息；2）术前管理和康复；3）肺叶切除术的麻醉和镇痛；4）肺叶切除术的手术策略；5）增强术后恢复。对于每个域，建议的目的是解决根据PICO模型制定的一些问题(人口，干预,比较,结果）。对这些问题进行了广泛的文献检索，并使用GRADE®方法进行了分析。建议是根据GRADE®方法制定的，然后由所有专家根据等级网格方法进行投票。
SFAR/SFCTCV指南小组提供了32项关于肺叶切除术患者管理的建议。经过两轮投票和几次修改，32项建议中的31项达成了强烈共识，上一项建议达成了适度共识。其中七项建议提供了高水平的证据(1+级)，23有中等程度的证据（18级2+和5级2-），和2对应于专家意见。最后,其中2个问题没有提供建议.
专家们表达了强烈的共识，为优化肺叶切除术患者的整个围手术期管理提供建议。
To establish recommendations for optimisation of the management of patients undergoing pulmonary lobectomy, particularly Enhanced Recovery After Surgery (ERAS).
A
consensus committee of 13 experts from the French Society of Anaesthesia and Intensive Care Medicine (Soci,t, franOaise d\'anesth,sie et de r,animation, SFAR) and the French Society of Thoracic and Cardiovascular Surgery (Soci,t, franOaise de chirurgie thoracique et cardiovasculaire, SFCTCV) was convened. A formal conflict-of-interest policy was developed at the onset of the process and enforced throughout. The entire
guidelines process was conducted independently of any industry funding. The authors were advised to follow the principles of the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system to guide assessment of quality of evidence.
Five domains were defined: 1) patient pathway and patient information; 2) preoperative management and rehabilitation; 3) anaesthesia and analgesia for lobectomy; 4) surgical strategy for lobectomy; and 5) enhanced recovery after surgery. For each domain, the objective of the recommendations was to address a number of questions formulated according to the PICO model (Population, Intervention, Comparison, Outcome). An extensive literature search on these questions was carried out and analysed using the GRADE® methodology. Recommendations were formulated according to the GRADE® methodology, and were then voted by all experts according to the GRADE grid method.
The SFAR/SFCTCV
guideline panel provided 32 recommendations on the management of patients undergoing pulmonary lobectomy. After two voting rounds and several amendments, a strong consensus was reached for 31 of the 32 recommendations and a moderate
consensus was reached for the last recommendation. Seven of these recommendations present a high level of evidence (GRADE 1+), 23 have a moderate level of evidence (18 GRADE 2+ and 5 GRADE 2-), and 2 correspond to expert opinions. Finally, no recommendation was provided for 2 of the questions.
A strong
consensus was expressed by the experts to provide recommendations to optimise the whole perioperative management of patients undergoing pulmonary lobectomy.
