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在subxiphoid胸腔镜解剖肺切除后的术后第1天排泄:一个单中心的术后增强恢复体验
Karel Pfeuty1, Dorian Rojas2, Jules Iquille1
1Department of Thoracic and Vascular Surgery, Yves Le Foll Hospital, Saint-Brieuc, France.
概括
肺部手术后的早期出院是安全有效的. 患者经过subxiphoid胸腔镜解剖肺切除可以在术后第一天安全地出院,显示出良好的恢复质量和遵守手术后增强恢复协议.
科学领域:
- 胸部外科手术 胸部外科手术
- 最少侵入性的手术
- 手术后增强恢复 (ERAS) 计划
背景情况:
- 手术后增强恢复 (ERAS) 计划旨在优化患者的康复并减少住院时间.
- 肺部切除术 (subxiphoid thoracoscopic anatomical lung resection) 是肺部手术的一种微创方法.
研究的目的:
- 评估手术后第一天 (POD) 退院的患者的安全性和康复质量 (QOR) 后,subxiphoid胸腔镜解剖肺切除.
- 评估一个先进的ERAS计划对提前释放结果的影响.
主要方法:
- 对从201名接受子体胸腔镜解剖肺切除的患者前性收集的数据进行了回顾性分析.
- 分析患者特征,术后数据,ERAS路径合规性和回家过渡QOR调查.
- 多变量后勤回归用于识别与POD 1排放相关的因素.
主要成果:
- 56%的患者 (113/201) 在POD1上获释,在下叶叶切除后的比例更高.
- POD 1排泄与年龄较大 (>74岁) 和经营时间较长有关,但也与更好的肺功能 (FEV1) 和复杂的亚叶切除有关.
- 早期的胸管切除 (POD 0/1) 和无阿片类药物止痛治疗在POD 1退院组中更为常见.
- 住院发病率为13%,90天再入院率为10% (POD 1退院组的较低),90天死亡率为0.5%.
结论:
- 在ERAS计划中,手术后的第1天排出是安全的和可行的,对于在ERAS计划中接受subxiphoid胸腔镜解剖肺切除的选定患者.
- 早期的胸管切除是ERAS途径的关键组成部分,有助于早期出院.
- 在POD 1上出院的患者经历了出色的结果和高质量的康复.
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