Study On The Application Of Enhanced Recovery After Surgery In The Perioperative Period Of Single-port Thoracoscopic Lung Resection

Objective Lung cancer is one of the most common malignant tumors worldwide,and its morbidity and mortality rates are gradually increasing.In the past few decades,most patients with lung cancer were admitted to hospital due to hemoptysis or chest tightness due to the economic situation and the lack of attention to physical examination.Most of them were found to have reached the middle and late stages of lung cancer,resulting in extremely low 5-year survival rate.And in recent years,with the national emphasis on health and the development of CT diagnostic technology,most early lung cancers can be diagnosed in time.With the development of technology,minimally invasive pulmonary surgery has long been widely popular,and single-port thoracoscopic lung resection has gradually taken an important place in minimally invasive pulmonary surgery.In recent years,the concept of enhanced recovery after surgery（ERAS）has gradually prevailed in China,and thoracic surgery scholars at home and abroad have tried to apply the concept of ERAS to the perioperative management of patients.This study fully applies the ERAS concept to the perioperative management of single-port thoracoscopic lung resection,with the aim of investigating the effectiveness of the accelerated rehabilitation surgery concept in the perioperative period of single-port thoracoscopic lung resection.Methods One hundred and twenty patients attending the Department of Thoracic Surgery,Fuyang Hospital,Anhui Medical University,from October 2019 to September2020 were diagnosed with non-small cell lung cancer preoperatively or intraoperatively.Two groups of patients underwent single-port thoracoscopic lung resection.According to the different perioperative respiratory management,diet management,postoperative pain management and postoperative nursing concepts,the subjects were randomly divided into the traditional group（group T）and the accelerated rehabilitation surgery group（group ERAS）,with 60 cases in each group.Retrospective analysis was performed to compare the age,gender,BMI,preoperative comorbidities,operating time,intraoperative bleeding,number of lymph nodes dissected,tumour location,tumour stage,postoperative activity time,postoperative defecation time,postoperative drain removal time,incidence of postoperative complications,postoperative analgesic use,postoperative pain scores at 6h,24 h,48h and 72 h,postoperative hospital stay and hospitalisation costs between the two groups.Results By comparison,there were no significant differences between the two groups in terms of age,gender,BMI,preoperative comorbidities,operative time,intraoperative bleeding,number of lymph nodes dissected,tumour location and tumour stage（p >0.05）.Compared to the conventional group,the ERAS group had significantly shorter time to activity,time to removal of drain and time to defecation after surgery（all P <0.01）,significantly lower postoperative complication rates（15% vs 35%,P < 0.05）,pain scores at 6h and 72 h postoperatively（all P < 0.01）,and less postoperative hospital stay and hospital costs（all P < 0.01）.However,there was no significant difference in the use of postoperative analgesics and pain scores at 24 h and 48 h after operation between the two groups（all P > 0.05）.Conclusion Single-port thoracoscopic lung resection under the guidance of ERAS theory can benefit perioperative patients,reduce the incidence of perioperative complications,postoperative costs,shorten hospitalization time,reduce postoperative pain and accelerate postoperative recovery.