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Electromagnetic Navigation Transthoracic Nodule Localization for Minimally Invasive Thoracic Surgery
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Enhanced recovery pathways in thoracic surgery: the Quebec experience
Julien Hubert1, Etienne Bourdages-Pageau1, Charles Antoine Paradis Garneau1
1Departments of Respirology and Thoracic Surgery, Institut Universitaire de Cardiologie et de Pneumologie de Québec, Québec, Canada.
Journal of Thoracic Disease
|April 10, 2018
Summary
Diagnostic Assessment Programs (DAPs) and Enhanced Recovery Protocols (ERPs) can expedite lung cancer care. These programs improve patient outcomes and align with healthcare system goals for efficiency and cost-effectiveness in thoracic surgery.
Area of Science:
- Thoracic Surgery
- Surgical Oncology
- Health Services Research
Background:
- Canada's universal healthcare system prioritizes cost-effectiveness.
- Diagnostic Assessment Programs (DAPs) and Enhanced Recovery Protocols (ERPs) aim to improve care timeliness and outcomes.
- The application of DAPs and ERPs in lung cancer patients undergoing VATS lobectomy remains debated.
Purpose of the Study:
- To measure the time from preoperative workup to treatment using a DAP for lung cancer patients.
- To evaluate the impact of an ERP on postoperative outcomes in early-stage NSCLC patients undergoing VATS lobectomy.
Main Methods:
- Retrospective review of patients undergoing minimally invasive lobectomy for lung cancer (Jan 2014 - May 2017).
- Measurement of care timelines, including time to surgery.
- Postoperative assessment of chest tube drainage duration, hospital stay, and complication rates.
Main Results:
- 384 of 646 (59%) patients with early-stage NSCLC were assessed within the DAP.
- Median time from clinic visit to surgery referral was 30 days; median time from surgical consult to treatment was 29 days.
- ERP implementation resulted in a median chest drainage of 3 days and a median hospital stay of 4 days.
Conclusions:
- DAPs and ERPs show potential in thoracic surgical practice.
- Rapid DAPs can accelerate lung cancer patient care trajectories and meet national standards.
- ERPs are feasible and effectively improve clinical outcomes in lung cancer surgery.
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