Effectiveness of the enhanced recovery after surgery (ERAS) program after lobectomy for lung cancer: a single-center observational study using propensity score matching in Vietnam.
Ho Tat Bang, Tran Thanh Vy, Le Quan Anh Tuan, Nguyen Lam Vuong, Lam Thao Cuong, Ha Quoc Hung, Phan Ton Ngoc Vu, Nguyen Van Tap
{"title":"Effectiveness of the enhanced recovery after surgery (ERAS) program after lobectomy for lung cancer: a single-center observational study using propensity score matching in Vietnam.","authors":"Ho Tat Bang, Tran Thanh Vy, Le Quan Anh Tuan, Nguyen Lam Vuong, Lam Thao Cuong, Ha Quoc Hung, Phan Ton Ngoc Vu, Nguyen Van Tap","doi":"10.21037/jtd-24-1053","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Postoperative complications and extended length of stays (LOS) following lobectomy for non-small cell lung cancer (NSCLC) remain significant healthcare and economic burdens, especially in developing countries with limited resources. This study evaluated the effectiveness of enhanced recovery after surgery (ERAS) protocols in addressing these issues.</p><p><strong>Methods: </strong>This observational study compared two groups of patients, utilizing a prospective arm for ERAS and a retrospective arm for routine care. Outcomes measured included postoperative LOS, complications, re-operations, and re-admissions. Propensity score matching (PSM) was used to adjust for potential confounders between the two groups.</p><p><strong>Results: </strong>Among 197 NSCLC patients (98 in the ERAS group and 99 in the routine care group), the PSM resulted in 63 patients in each group. After PSM, the ERAS group experienced a significantly shorter postoperative LOS compared to the routine group (median: 4.6 <i>vs.</i> 5.1 days, P=0.01). There were no significant differences in postoperative complication and re-operative rates between the two groups. However, the ERAS group had a significantly lower postoperative 30-day re-admission rate of 1.6%, compared to 14.3% in the routine care group (P=0.02).</p><p><strong>Conclusions: </strong>In NSCLC patients who underwent lobectomy, ERAS protocols improve postoperative outcomes by reducing LOS and re-admission rates. Therefore, ERAS should be considered a replacement for routine protocols in developing countries to minimize healthcare and economic burdens.</p>","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"16 11","pages":"7686-7696"},"PeriodicalIF":2.1000,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11635212/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of thoracic disease","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.21037/jtd-24-1053","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/11/12 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"RESPIRATORY SYSTEM","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Postoperative complications and extended length of stays (LOS) following lobectomy for non-small cell lung cancer (NSCLC) remain significant healthcare and economic burdens, especially in developing countries with limited resources. This study evaluated the effectiveness of enhanced recovery after surgery (ERAS) protocols in addressing these issues.
Methods: This observational study compared two groups of patients, utilizing a prospective arm for ERAS and a retrospective arm for routine care. Outcomes measured included postoperative LOS, complications, re-operations, and re-admissions. Propensity score matching (PSM) was used to adjust for potential confounders between the two groups.
Results: Among 197 NSCLC patients (98 in the ERAS group and 99 in the routine care group), the PSM resulted in 63 patients in each group. After PSM, the ERAS group experienced a significantly shorter postoperative LOS compared to the routine group (median: 4.6 vs. 5.1 days, P=0.01). There were no significant differences in postoperative complication and re-operative rates between the two groups. However, the ERAS group had a significantly lower postoperative 30-day re-admission rate of 1.6%, compared to 14.3% in the routine care group (P=0.02).
Conclusions: In NSCLC patients who underwent lobectomy, ERAS protocols improve postoperative outcomes by reducing LOS and re-admission rates. Therefore, ERAS should be considered a replacement for routine protocols in developing countries to minimize healthcare and economic burdens.
背景：非小细胞肺癌（NSCLC）肺叶切除术后并发症和延长住院时间（LOS）仍然是重大的医疗和经济负担，尤其是在资源有限的发展中国家。本研究评估了加强术后恢复（ERAS）方案在解决这些问题方面的有效性：这项观察性研究对两组患者进行了比较，前瞻性部分采用ERAS，回顾性部分采用常规护理。测量的结果包括术后住院时间、并发症、再次手术和再次入院。采用倾向评分匹配法（PSM）来调整两组患者之间的潜在混杂因素：在197名NSCLC患者中（ERAS组98人，常规护理组99人），倾向得分匹配法使两组各有63名患者。PSM 后，ERAS 组的术后 LOS 明显短于常规组（中位数：4.6 天 vs. 5.1 天，P=0.01）。两组的术后并发症和再次手术率没有明显差异。然而，ERAS组术后30天再次入院率为1.6%，明显低于常规护理组的14.3%（P=0.02）：在接受肺叶切除术的 NSCLC 患者中，ERAS 方案可通过降低 LOS 和再入院率来改善术后效果。因此，在发展中国家，ERAS应被视为常规方案的替代方案，以最大限度地减轻医疗和经济负担。
期刊介绍：
The Journal of Thoracic Disease (JTD, J Thorac Dis, pISSN: 2072-1439; eISSN: 2077-6624) was founded in Dec 2009, and indexed in PubMed in Dec 2011 and Science Citation Index SCI in Feb 2013. It is published quarterly (Dec 2009- Dec 2011), bimonthly (Jan 2012 - Dec 2013), monthly (Jan. 2014-) and openly distributed worldwide. JTD received its impact factor of 2.365 for the year 2016. JTD publishes manuscripts that describe new findings and provide current, practical information on the diagnosis and treatment of conditions related to thoracic disease. All the submission and reviewing are conducted electronically so that rapid review is assured.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
