■胸外科手术中的增强术后恢复(ERAS)方案已被证明会影响住院时间(LOS),并发症发生率,和术后阿片类药物的使用。然而,用于微创肺切除术的ERAS方案尚未得到很好的描述。鉴于现在大多数肺切除术都是微创的,在这种情况下,有关ERAS方案的有效性的文献存在空白.在这项研究中,我们分析了实施ERAS微创肺切除术方案后的患者结局.
■回顾性收集了442例1月1日之间接受微创肺切除术的患者的预后数据,2015年10月26日,2021年。患者分为ERAS前(n=193)或ERAS(n=249)组。主要结果包括LOS,术后并发症,重症监护病房(ICU)入院情况,30天再次住院,30天死亡率次要结果包括胸外科医师协会(STS)数据库所需的常见术后并发症。
■我们观察到LOS中位数总体下降(4.0与3.0天,P=0.030)和ICU入院状态(15%vs.7.6%,P=0.020)在实施我们的ERAS协议后。解剖肺切除术的LOS差异显着降低,但不是非解剖切除.两组的30天再入院率和0%的死亡率没有差异。总的来说,两组之间的并发症发生率较低.
■ERAS方案的实施导致接受微创肺切除术的患者的LOS降低和ICU入院减少。流程标准化通过减少决策疲劳和改进决策来优化提供商的性能,这可能有助于改善本研究中观察到的结果。
UNASSIGNED: Enhanced recovery after surgery (ERAS) protocols in thoracic surgery have been demonstrated to impact length of stay (LOS), complication rates, and postoperative opioid use. However, ERAS protocols for minimally invasive lung resections have not been well described. Given most lung resections are now performed minimally invasively, there is a gap in the literature regarding the efficacy of ERAS protocols in this setting. In this study, we analyzed patient outcomes following implementation of an ERAS protocol for minimally invasive lung resections.
UNASSIGNED: Outcome data was retrospectively collected for 442 patients undergoing minimally invasive lung resections between January 1st, 2015 and October 26th, 2021. Patients were divided into either a pre-ERAS (n=193) or ERAS (n=249) group. Primary outcomes included LOS, postoperative complications, intensive care unit (ICU) admission status, 30-day hospital readmissions, and 30-day mortality. Secondary outcomes included common postoperative complications required for the Society for Thoracic Surgeons (STS) database.
UNASSIGNED: We observed an overall decrease in median LOS (4.0 vs. 3.0 days, P=0.030) and ICU admission status (15% vs. 7.6%, P=0.020) after implementation of our ERAS protocol. The difference in LOS was significantly lower for anatomic lung resections, but not non-anatomic resections. There was no difference in 30-day readmissions and a 0% mortality rate in both groups. Overall, there was a low complication rate that was similar between groups.
UNASSIGNED: The implementation of an ERAS protocol led to decreased LOS and decreased ICU admission in patients undergoing minimally invasive lung resection. Process standardization optimizes performance by providers by decreasing decision fatigue and improving decision making, which may contribute to the improved outcomes observed in this study.