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Updated: May 23, 2025
Author Spotlight: A Non-Intubated Video-Assisted Thoracoscopic Surgery with Multimodal Analgesia and Sevoflurane Inhalation Anesthesia
Published on: May 26, 2023
Physical activity after video-assisted thoracoscopic lung resection following an enhanced recovery after
Christian Galata1, Melanie Frey1, Bernhard Gohrbandt1
1Department of Thoracic Surgery, University Medical Center, Johannes-Gutenberg University Mainz, Mainz, Germany.
Background:
Early postoperative physical activity (PPA) is crucial for recovery and complication prevention after lung surgery. This study evaluates PPA in patients undergoing video-assisted thoracoscopic (VATS) lung resection within an enhanced recovery after surgery (ERAS) protocol.
Methods:
The Pulmonary Function after Thoracic Surgery (PATHOS) trial was a prospective, single-arm, single-center observational study that measured PPA of 62 patients scheduled for VATS lung resection between April 2022 and July 2023. A wrist-worn activity tracker was used to determine PPA until discharge or for a maximum of 5 postoperative days (PODs).
Results:
The median number of steps on POD 1 was 247 [34-616] and increased to 4,455 [2,099-5,514] on POD 5 (P<0.001). The median duration of PPA on POD 1 was 2 [0-4] minutes and increased to 37 [15-48] minutes on POD 5 (P<0.001). For 11 (17.7%) patients, zero steps were recorded on POD 1. Both the daily number of steps (P<0.001) and the duration of PPA (P=0.001) approximately tripled after chest tube removal. No complications ≥ grade 3 were observed.
Conclusions:
Chest tube removal has a major impact on postoperative mobilization after thoracoscopic lung resection. However, the general level of PPA in this study was low despite an ERAS setting. Further studies are needed to determine what level of PPA is required to improve patient outcomes and how ERAS-based protocols can contribute to these efforts.
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