Application Of Enhanced Recovery After Surgery In Erioperative Period Of Uniportal Thoracoscopic Lobectomy

Objective:To investigate the prognostic efficacy and feasibility of Uniportal thoracoscopic lobectomy combined with enhanced recovery after surgery(ERAS)management model in the clinical application of early and medium-term non-small cell lung cancer.Methods:The thoracic surgery department of Shanxi Provincial People’s Hospital has carried out perioperative management of patients according to ERAS concept since the end of 2020.According to the inclusion and exclusion criteria,a total of 50 patients in a treatment group of our department who were managed according to eras path and underwent uniportal thoracoscopic lobectomy+ mediastinal lymph node dissection from December 2020 to December 2021 were retrospectively collected as ERAS group.50 patients in the same treatment group treated with uniportal thoracoscopic lobectomy +mediastinal lymph node dissection from November 2018 to November 2019 were randomly selected as the control group.The basic data and perioperative results of the two groups were compared,such as preoperative treatment measures,intraoperative related data and postoperative recovery indicators.Results:(1)There was no significant difference between the two groups in basic information,operation time,intraoperative bleeding,number of intraoperative lymph node dissection and postoperative examination(p > 0.05);(2)Compared with the control group,the postoperative complications in ERAS group were divided into postoperative air leakage(2% vs.16%,p = 0.031),pulmonary infection(6% vs.26%,p = 0.006),pleural effusion(4% vs.20%,p= 0.014),atelectasis(4% vs.22%,p = 0.007),thrombosis(2% vs.18%,p =,0.008)and incision infection(2% vs.6%,p = 0.617),which were statistically significant except incision infection.(3)Compared with the control group,the retention time of drainage tube in ERAS Group [(82.10±23.03)h vs.(147.43±39.43)h,p = 0.000];Compared with the control group,the VAS scores of ERAS group [8(5-10)vs.8(5-10),p = 0.002],[7(5-9)vs.8(4-10),p= 0.012],[5.5(3-7)vs.6(4-9),p < 0.000] were significantly lower than those of the control group.The postoperative hospital stay was [6.05±1.54 days in eras group and 7.37±2.24 days in control group(p = 0.001)].The total hospital stay in ERAS group was [10.19±3.27 d,12.71±4.83 d in control group(p= 0.003)];The hospitalization expenses [(57148.11±8223.97)yuan vs.(68872.06±12317.48)yuan,p < 0.000] were less than those in the control group.Conclusion:Compared with the control group,NSCLC patients undergoing unipotal thoracoscopic lobectory combined with enhanced recovery after surgical management path can significantly reduce the incidence of postoperative complications,shorten hospital stay and reduce hospital expenses.It is beneficial to the postoperative rehabilitation of patients and is worth popularizing.