Perioperative Lung Resection Outcomes After Implementation of a Multidisciplinary, Evidence-based Thoracic ERAS...

Area of Science:

• Thoracic Surgery
• Surgical Outcomes
• Evidence-Based Medicine

Background:

• Enhanced Recovery After Surgery (ERAS) programs show promise for improving patient outcomes.
• However, ERAS programs are not yet widely adopted in thoracic surgery.

Purpose of the Study:

• To evaluate the impact of a multidisciplinary, evidence-based Thoracic ERAS Program on perioperative lung resection outcomes.
• To assess the effectiveness of ERAS Society thoracic guidelines in a real-world clinical setting.

Main Methods:

• Prospective study of 295 patients undergoing elective lung resection for pulmonary malignancy (2015-2019).
• Comparison of outcomes before (PRE) and after (POST) ERAS program implementation.
• Propensity score-matched analysis to control for patient, tumor, and surgical variables.

Main Results:

• ERAS implementation increased minimally invasive surgery rates and early removal of chest tubes and urinary catheters.
• Significant reductions observed in intensive care unit utilization, length of stay, morbidity, opioid use, and direct costs.
• No significant change in patient readmission rates was noted.

Conclusions:

• The Thoracic ERAS Program effectively reduced length of stay, morbidity, opioid consumption, and costs for lung resection patients.
• This study provides external validation for the ERAS Society thoracic guidelines.
• Adoption of this ERAS program by other institutions may yield similar benefits.