Impact of Compliance With Components of an ERAS Pathway on the Outcomes of Anatomic VATS Pulmonary Resections.

Details

Serval ID
serval:BIB_9583230729C5
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Impact of Compliance With Components of an ERAS Pathway on the Outcomes of Anatomic VATS Pulmonary Resections.
Journal
Journal of cardiothoracic and vascular anesthesia
Author(s)
Forster C., Doucet V., Perentes J.Y., Abdelnour-Berchtold E., Zellweger M., Marcucci C., Krueger T., Rosner L., Gonzalez M.
ISSN
1532-8422 (Electronic)
ISSN-L
1053-0770
Publication state
Published
Issued date
07/2020
Peer-reviewed
Oui
Volume
34
Number
7
Pages
1858-1866
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
Implementation of an Enhanced Recovery After Surgery (ERAS) program is associated with better postoperative outcomes. The aim of this study was to evaluate the impact of ERAS compliance (overall and to specific elements of the program) on them.
Retrospective analysis of prospectively collected data.
University hospital, monocentric.
All adult (≥18 years old) patients undergoing video-assisted thoracic surgery (VATS) anatomic pulmonary resection.
ERAS-governed VATS anatomic pulmonary resection.
Demographics, surgical characteristics and pre-, peri-, and postoperative compliance with 16 elements of the ERAS program were assessed. Postoperative outcomes and length of stay were compared between low- (<75% of adherence) and high-compliance (≥75%) groups. From April 2017 to November 2018, 192 ERAS patients (female/male: 98/94) of median age of 66 years (interquartile range 58-71) underwent VATS resection (109 lobectomies, 83 segmentectomies). There was no 30-day mortality and resurgery rate was 5.7%. Overall ERAS compliance was 76%. High compliance was associated with fewer complications (18% v 48%, p < 0.0001) and lower rate of delayed discharge (37% v 60%, p = 0.0013). Early removal of chest tubes (odds ratio [OR]: 0.26, p < 0.002), use of electronic drainage (OR: 0.39, p = 0.036), opioid cessation on day 3 (OR: 0.28, p = 0.016), and early feeding (OR: 0.12, p = 0.014) were associated with reduced rates of postoperative complications. Shorter hospital stay was correlated with early removal of chest tubes (OR: 0.12, p < 0.0001) and opioid cessation on day 3 (OR: 0.23, p = 0.001).
High ERAS compliance is associated with better postoperative outcomes in patients undergoing anatomic pulmonary VATS resections.
Keywords
Enhanced recovery, Lobectomy, Lung cancer, Segmentectomy, Video-assisted thoracic surgery
Pubmed
Web of science
Open Access
Yes
Create date
09/07/2020 11:06
Last modification date
17/04/2021 6:34
Usage data