Experience with lung resection in a fast-track surgery program

This paper intends to assess the influence of a fast-track surgery program on hospital stay and morbidity/mortality in lung resection surgery.

A prospective study including 100 patients who underwent open lung resection due to neoplastic pathologies. The variables analyzed were demographic, clinical, resection type, length of hospital stay and postoperative complications, adjusting these to the classification established according to the treatment required.

Seventy-three patients were men, and mean age was 60.8. 82% of the subjects were asymptomatic, 97% had a history of smoking and the majority presented associated comorbidities. The resection types included 7 pneumonectomies, 79 lobectomies, 6 bilobectomies and 8 segmentectomies. Mean hospital stay was 5.4±4.2 days (range: 3-23), varying between 3.4±0.8 days (range: 3-6) and 9.8±5.3 days (range: 4-23) according to the absence or presence of complications. Associated mortality was 2% and morbidity 31%; the most frequent complications were persistent air leak (10%) and atrial fibrillation (6%). 51.5% of the complications were classified within the lower grade complication group, depending on treatment required. Four patients required readmittance after hospital discharge.

Fast-track surgery programs are able to reduce hospitalization times by planning a multidisciplinary strategy of the surgical procedure, in which the patient him/herself participates. It is equally necessary to establish systems to classify postoperative complications that can evaluate the quality of the surgery.