The Study Of The Application Of Fast-track Surgery In Lobectomy For Lung Cancer

Objective Fast-track surgery(FTS) refers to the preoperative, intraoperative and postoperative application of methods which has been proved effective to reduce the surgical stress and postoperative complications, accelerate the postoperative recovery, shorter hospital stay, and reduce hospitalization cost. This study was to explore the feasibility and superiority of fast-track surgery(FTS) concept in lobectomy and video assisted lobectomy for lung cancer.Methods From June 2013 to June 2015, 216 cases of lung cancer who received lobecetomy were randomly divided into A, B, C and D four groups. The surgery of Groups A and B were completed with the distraction device via posterior thoracotomy incision, Group C and D received video-assisted thoracoscopic surgery(VATS) with two incisions. Patients of Group A and C were conventionally managed, and Group B and D were with fast-track surgery concept. FTS concept includes: keeping intraoperative warming, intraoperative and postoperative fluid restriction, postoperative early ambulation, the use of pleural fluid less than 300 ml/d for chest tube removal. Collect the general information and operation time, blood loss, incision length, ambulation time, drainage time, postoperative hospitalization duration, postoperative cost, pain score(VAS), patient number of thoracocentesis and complications of four groups, then compare the differences between groups.Results Patients were underwent lobectomy successfully in four groups.The operative time, blood loss, postoperative pleural puncture rate and incidence of postoperative complications of four groups have no significant differences(p > 0.05). However, compared to group A and C, the postoperative three days VAS score, postoperative ambulation time, postoperative chest tube removal time, postoperative hospital stay and postoperative cost were reduced in group B and D(p < 0.05). Compared to group A and B, the three days VAS score was lower(p < 0.05), the postoperative ambulation time and postoperative chest tube removal time was earlier(p < 0.05), the postoperative hospital stay was shorted(p < 0.05) and the cost was reduced(p < 0.05).Conclusions The application of FTS concept in lung cancer surgeries can help reduce postoperative pain, shorten postoperative under activity time, drainage time and hospitalization time, the hospitalization cost was significantly lower, which helps recover rapidly and obtain maximum benefit.