The Application Of Enhanced Recovery After Surgery In Patients Of Thoracoscopic Pulmonary Resections

ObjectiveTo explore the safety and efficacy of enhanced recovery after surgery(ERAS)concept in patients undergoing thoracoscopic pulmonary resections.MethodsA retrospective collection of 139 patients who underwent Thoracoscopic pulmonary resections at the Department of Thoracic Surgery of the First Affiliated Hospital of Chongqing Medical University from January 2016 to November 2017.From January 2016 to January 2017,77 patients managed under the traditional rehabilitation model were the control group.From February 2017 to November 2017,62 patients were guided by the concept of enhanced recovery after surgery were ERAS group.Comparing the basic information(gender,age,height,weight,BMI,ASA classification),surgical related data(surgical time,intraoperative blood loss,intraoperative fluid volume,intraoperative urine volume,postoperative disease examination),postoperative recovery related data(postoperative complications,tracheal tube removal,ICU length of stay,urinary catheter removal,chest tube removal,postoperative hospital stay,total length of hospital stay,hospitalization costs,medical satisfaction).All data in the study were analyzed using SPSS 17.0 software.Results(1)There was no significant difference in basic information,operation time,intraoperative blood loss,intraoperative urine volume,surgical methods,and postoperative disease examination between the ERAS group and the control group(P<0.05).The two groups are comparable.(2)ERAS group compared with the control group,ERAS group's postoperative complications such as pulmonary infection(8.1%vs.10.4%,P =0.640),air leakage(6.5%vs.13.0%,P=0.203),incision infection(1.6%vs.1.3%,P=1.000),pleural effusion(1.6%vs.1.3%,p=1.000),and recurrent laryngeal nerve injury(1.6%vs.1.3%,P=1.000)was lower than that of the control group,but the difference was not statistically significant.(3)Compared to the control group,ERAS group's tracheal tube removal(2.47±1.31h vs.3.29±1.24h,p?0.001),ICU length of stay(17.20±12.98h vs.34.10±20.47h,p ?0.001),urinary catheter removal(20.55±12.64h vs.36.65±20.55h,P ? 0.001),chest tube removal(82.02±54.24h vs.111.58±60.57h,P=0.004),post-operative length of hospital stay(4.87±2.80d vs.6.29± 3.48d,P=0.001),total hospital stay(9.47±4.64d vs.11.43±5.42d,P=0.025)and hospitalization costs(?54861.59±17627.46 vs.?70281.00+57732.68,P=0.045)were less than the control group,and the differences were statistically significant.ERAS group's satisfaction with treatment(10-point scale)(9.24±0.64 vs.8.94±0.92,P=0.023)was significantly higher than that of the control group.ConclusionFor thoracic surgery patients undergoing thoracoscopic pulmonary resections,the application of enhanced recovery after surgery management can shorten hospital stay,reduce hospitalization costs,and improve satisfaction.Enhanced recovery after surgery is safe and feasible for thoracoscopic pulmonary resections.It is worthy of clinical promotion.