Evaluation And Analysis Of The Effect Of Accelerated Rehabilitation Surgery On The Perioperative Period Of Thoracoscope Non-small Cell Lung Cancer

Objective: Analyze the effect of accelerated rehabilitation surgery in thoracoscopic lung tumor resection,explore the feasibility and safety of its application,and analyze the factors that affect the application of accelerated rehabilitation surgery.Methods: Since the center began to contact and try out the accelerated rehabilitation surgery model in early 2018,after a year of continuous exploration and summary,a more thorough and systematic rapid rehabilitation surgery program was implemented at the end of 2018.Therefore,this study retrospectively analyzed the clinical data of patients undergoing radical thoracoscopic non-small cell lung cancer(NSCLC)lung cancer surgery in the center in 2017 and 2019.A total of 162 patients were enrolled.Fifty-eight patients in 2017 who have not yet implemented the accelerated rehabilitation surgery program were assigned to the Conservative Treatment Surgery(CTS)group,and 99 patients in2019 were set to the perioperative ERAS group.This study has two content,the first content: by comparing and analyzing the differences in postoperative complications,postoperative hospital stay,chest tube retention time,and total hospitalization costs between the two groups of patients to evaluate the implementation of accelerated rehabilitation surgery program Effect.Part 2:Explore the relationship between postoperative complications of lung cancer and various factors during the perioperative period,and continue to optimize lung tumor resection Provide reference basis for perioperative treatment plan.Results:1.An analysis of 162 patients included in the study showed that there was no statistically significant difference in preoperative general data such as gender,age,pathology,chronic disease,smoking index,body mass index,FEV1/FEV among the groups(P﹥0.05),You can compare the effects of two sets of applications.2.The complication rate in the CTS group was 37.9%(22 cases),and the complication rate in the ERAS group was 20.2%(20 cases).The difference was statistically significant(P<0.05).The postoperative hospital stay in the CTS group was [11(6,23)] days,which was longer than the [9(5,14)] days in the ERAS group.The difference was statistically significant(P<0.05).Chest tube indwelling time [5(4,9)] days in the CTS group was longer than [3(2,6)] days in the ERAS group,the difference was statistically significant(P<0.05).There was no significant difference in total hospitalization costs between the two groups(P﹥0.05).3.The incidence of postoperative complications is an important evaluation index for accelerating the application of the concept of rehabilitation surgery.Further analysis of the high-risk factors affecting postoperative complications.After screening,single-factor analysis of risk factors showed statistically significant differences in age,body mass index,operation time,diabetes,FEV1/FEV smoking index,and surgical method(P<0.05).Multivariate logistic regression analysis of the above risk factors showed that: age(P=0.05,OR=0.298,95.0%CI 0.128～0.694),body mass index(P=0.048,OR=2.527,95.0%CI 1.010～6.322)1.Smoking index(P=0.038,OR=0.371,95.0%CI0.145～0.947),FEV1/FEV(P=0.018,OR=3.225,95.0%CI 1.222～8.511),diabetes(P=0.002,OR=0.233,95.0%CI 0.092～0.592),surgical method(P=0.034,OR=0.378,95.0%CI 0.153～0.930)were independent risk factors for complications after thoracoscopic lung tumor resection.Conclusions:Compared with the traditional surgical surgical plan(CTS group),the rapid rehabilitation plan(ERAS group)in the perioperative period of thoracoscopic lung tumor resection can effectively reduce the stress-induced trauma and reduce the surgical complications.Morbidity,shorten the postoperative hospital stay and postoperative extubation time,and promote the rehabilitation of patients,so it is considered feasible,safe,and efficient.The incidence of postoperative complications of lung cancer is high,and it obviously affects the therapeutic effect of surgery.According to the risk factors of postoperative complications,active intervention should be made to improve the ERAS program in a targeted manner to reduce the risk of perioperative complications.To speed up the patient’s postoperative recovery.