Enhanced Lung Rehabilitation after Surgery: Peri-operative Processes Optimization Is Necessary_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

 CHEGuo-wei ¹ , LIWei-min ² , LIuLun-xu ¹

1. Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;
2. Department of Respiratory Medicine, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;

Corresponding author：

CHEGuo-wei, Email: guowei_che@yahoo.com

Keywords：

Minimally invasive thoracic surgery; Pain and risk free ward; Enhanced recovery after surgery; Perioperative regimen care management

DOI：

10.7507/1007-4848.20160051

Video：

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The concept of "enhanced recovery after surgery (ERAS)" has been well known by care providers. Implementation of the ERAS principles requires minimally invasive surgical technology in conjunction with multidisciplinary teamwork. Only if these two aspects of peri-operative care regime optimization and "all-in-one model in medical" care were linked up associatelly, ERAS could be realized. Thoracoscopic surgery was a milestone in thoracic surgery. The successful application of such a recovery program requires the foundation of pain and risk free ward in perioperative period and improving quality of life post discharge. This review summarizes the peri-operative regimen care optimization regarding the utility of ERAS in the VATS lobectomy of patients with lung cancer. The first one is preoperative evaluation issues. It involves conditioning the patient and implementing a pre-operative exercise and a physical therapy regimen. The second one is operative and individual anesthetic maneuvers and the selective use of tube in the post-operative period. The third one is the foundation of pain and risk free ward:what are methods optimum of post operative management? The fourth one is medical management of patient's outcomes and the ERAS regimen continuing optimum. The fifth one is the importance of function of multi-departmental coordination in ERAS.

Citation： CHEGuo-wei, LIWei-min, LIuLun-xu. Enhanced Lung Rehabilitation after Surgery: Peri-operative Processes Optimization Is Necessary. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2016, 23(3): 216-220. doi: 10.7507/1007-4848.20160051 Copy

1.	王正国. 外科学发展的回顾和展望. 中国医科大学学报, 2013, 42(4): 289-292.
2.	Kehlet H, Wilmore DW. Multimodal strategies to improve surgical outcome. Am J Surg, 2002, 183(6): 630-641.
3.	Spanjersberg WR, van Sambeeck JDP, Bremers A, et al. Systematic review and meta-analysis for laparoscopic versus open colon surgery with or without an ERAS programme. Surg Endosc, 2015, 29(12): 3443-3453.
4.	Holbek BL, Horsleben Petersen R, Kehlet H, et al. Fast-track video-assisted thoracoscopic surgery: future challenges. Scand Cardiovasc J, 2015:1-5[Epub ahead of print].
5.	车国卫, 梅龙勇, 梅建东, 等. 单操作孔电视胸腔镜手术治疗肺部疾病158例临床分析. 中国胸心血管外科临床杂志, 2012, 19(2): 116-119.
6.	田龙, 沈诚, 车国卫. 肺部磨玻璃密度影研究的现状与进展. 中国胸心血管外科临床杂志, 2015, 22(4): 371-374.
7.	Schatz C. Rnhanced recovery in a minimally invasive thoracic surgery program. AORN J, 2015, 102(5): 482-492.
8.	Gao K, Yu PM, Su JH, et al. Cardiopulmonary exercise testing screening and pre-operative pulmonary rehabilitation reduce postoperative complications and improve fast-track recovery after lung cancer surgery: A study for 342 cases. Thorac Cancer, 2015, 6(4): 443-449.
9.	Mei J, Liu L, Tang M, et al. Airway bacterial colonization in patients with non-small cell lung cancer and the alterations during the perioperative period. J Thorac Dis, 2014, 6(9): 1200-1208.
10.	沈春辉, 梅龙勇, 喻鹏铭, 等. 术前肺康复对肺癌合并中-重度慢性阻塞性肺疾病患者运动耐力影响. 中国胸心血管外科临床杂志, 2011, 18(6): 514-517.
11.	沈春辉, 车国卫. 肺康复在肺癌围手术期应用现状与进展. 中国康复医学杂志, 2011, 26(7): 686-689.
12.	Che GW, Yu PM, Su JH, et al. Cardio-pulmonary exercise capacity in patients with lung cancers: a comparison study between video-assisted thoracoscopic lobectomy and thoracotomy lobectomy.Sichuan Da Xue Xue Bao Yi Xue Ban, 2013, 44(1): 122-125.
13.	Pompeo E. Non-intubated thoracic surgery: nostalgic or reasonable? Ann Transl Med, 2015, 3(8): 99.
14.	苏建华, 周渝斌, 蒲强, 等. 影响肺癌手术住院费用和快速康复的临床因素分析. 中国肺癌杂志, 2014, 17(7): 536-540.
15.	杨思悦, 苏兰, 龚仁蓉, 等. 胸腔镜肺叶切除术:器械包模块化应用的临床评价. 生物医学工程与临床, 2014, 18(3): 255-258.
16.	邱舫, 杨梅, 王维, 等. 肺叶切除术后患者无尿管留置的前瞻性队列研究. 中国胸心血管外科临床杂志, 2015, 22(7): 634-637.
17.	Shi H, Mei L, Che G. The current concepts of closed chest drainage in lobectomy of lung cancer. Zhongguo Fei Ai Za Zhi, 2010, 13(11): 999-1003.
18.	杨梅, 樊骏, 周红霞, 等.胸腔镜肺癌肺叶切除术后16F较28F胸腔引流管应用的临床优势. 中国肺癌杂志, 2015, 18(8): 512-517.
19.	Xie HY, Xu K, Tang JX, et al. A prospective randomized, controlled trial deems a drainage of 300 ml/day safe before removal of the last chest drain after video-assisted thoracoscopic surgery lobectomy. Interact Cardiovasc Thorac Surg, 2015, 21(2): 200-205.
20.	Kim SS, Khalpey Z, Daugherty SL, et al. Factors in the selection and management of chest tubes after pulmonary lobectomy: results of a national survey of thoracic surgeons. Ann Thorac Surg, 2015, pii: S0003-4975(15)01587-01588. doi: 10.1016/j.athoracsur.2015.09.079.[Epub ahead of print].
21.	Zatevakhin Ⅱ, Pasechnik IN, Gubaidullin RR, et al. Accelerated postoperative rehabilitation: multidisciplinary issue (Part 1). Khirurgiia (Mosk), 2015, 9: 4-8.
22.	马丹, 杨梅, 樊骏, 等. 胸腔镜肺叶切除术后引流管管径对患者舒适度影响的前瞻性队列研究. 中国胸心血管外科临床杂志, 2015, 22(10): 928-931.
23.	鲍珊, 苏建华, 廖虎, 等. 合并慢性阻塞性肺病和手术方式对肺癌患者术后快速康复及治疗费用的影响. 中国胸心血管外科临床杂志, 2014, 21(1): 17-20.
24.	宋志芳, 韩兆杰, 林琳, 等. SF-36量表评价胸外科住院患者生活质量的信度和效度.中国胸心血管外科临床杂志, 2014, 21(2): 164-167.
25.	Fagundes CP, Shi Q, Vaporciyan AA, et al. Symptom recovery after thoracic surgery: Measuring patient-reported outcomes with the MD Anderson Symptom Inventory. J Thorac Cardiovasc Surg, 2015, 150(3):613-619.
26.	周渝斌, 刘伦旭, 喻鹏铭, 等. 胸腔镜肺叶切除术后心肺功能的快速康复. 中国胸心血管外科临床杂志, 2013, 20(2): 168-171.
27.	Hübner M, Addor V, Slieker J, et al. The impact of an enhanced recovery pathway on nursing workload: A retrospective cohort study. Int J Surg, 2015, 24(Pt A): 45-50.

1. 王正国. 外科学发展的回顾和展望. 中国医科大学学报, 2013, 42(4): 289-292.
2. Kehlet H, Wilmore DW. Multimodal strategies to improve surgical outcome. Am J Surg, 2002, 183(6): 630-641.
3. Spanjersberg WR, van Sambeeck JDP, Bremers A, et al. Systematic review and meta-analysis for laparoscopic versus open colon surgery with or without an ERAS programme. Surg Endosc, 2015, 29(12): 3443-3453.
4. Holbek BL, Horsleben Petersen R, Kehlet H, et al. Fast-track video-assisted thoracoscopic surgery: future challenges. Scand Cardiovasc J, 2015:1-5[Epub ahead of print].
5. 车国卫, 梅龙勇, 梅建东, 等. 单操作孔电视胸腔镜手术治疗肺部疾病158例临床分析. 中国胸心血管外科临床杂志, 2012, 19(2): 116-119.
6. 田龙, 沈诚, 车国卫. 肺部磨玻璃密度影研究的现状与进展. 中国胸心血管外科临床杂志, 2015, 22(4): 371-374.
7. Schatz C. Rnhanced recovery in a minimally invasive thoracic surgery program. AORN J, 2015, 102(5): 482-492.
8. Gao K, Yu PM, Su JH, et al. Cardiopulmonary exercise testing screening and pre-operative pulmonary rehabilitation reduce postoperative complications and improve fast-track recovery after lung cancer surgery: A study for 342 cases. Thorac Cancer, 2015, 6(4): 443-449.
9. Mei J, Liu L, Tang M, et al. Airway bacterial colonization in patients with non-small cell lung cancer and the alterations during the perioperative period. J Thorac Dis, 2014, 6(9): 1200-1208.
10. 沈春辉, 梅龙勇, 喻鹏铭, 等. 术前肺康复对肺癌合并中-重度慢性阻塞性肺疾病患者运动耐力影响. 中国胸心血管外科临床杂志, 2011, 18(6): 514-517.
11. 沈春辉, 车国卫. 肺康复在肺癌围手术期应用现状与进展. 中国康复医学杂志, 2011, 26(7): 686-689.
12. Che GW, Yu PM, Su JH, et al. Cardio-pulmonary exercise capacity in patients with lung cancers: a comparison study between video-assisted thoracoscopic lobectomy and thoracotomy lobectomy.Sichuan Da Xue Xue Bao Yi Xue Ban, 2013, 44(1): 122-125.
13. Pompeo E. Non-intubated thoracic surgery: nostalgic or reasonable? Ann Transl Med, 2015, 3(8): 99.
14. 苏建华, 周渝斌, 蒲强, 等. 影响肺癌手术住院费用和快速康复的临床因素分析. 中国肺癌杂志, 2014, 17(7): 536-540.
15. 杨思悦, 苏兰, 龚仁蓉, 等. 胸腔镜肺叶切除术:器械包模块化应用的临床评价. 生物医学工程与临床, 2014, 18(3): 255-258.
16. 邱舫, 杨梅, 王维, 等. 肺叶切除术后患者无尿管留置的前瞻性队列研究. 中国胸心血管外科临床杂志, 2015, 22(7): 634-637.
17. Shi H, Mei L, Che G. The current concepts of closed chest drainage in lobectomy of lung cancer. Zhongguo Fei Ai Za Zhi, 2010, 13(11): 999-1003.
18. 杨梅, 樊骏, 周红霞, 等.胸腔镜肺癌肺叶切除术后16F较28F胸腔引流管应用的临床优势. 中国肺癌杂志, 2015, 18(8): 512-517.
19. Xie HY, Xu K, Tang JX, et al. A prospective randomized, controlled trial deems a drainage of 300 ml/day safe before removal of the last chest drain after video-assisted thoracoscopic surgery lobectomy. Interact Cardiovasc Thorac Surg, 2015, 21(2): 200-205.
20. Kim SS, Khalpey Z, Daugherty SL, et al. Factors in the selection and management of chest tubes after pulmonary lobectomy: results of a national survey of thoracic surgeons. Ann Thorac Surg, 2015, pii: S0003-4975(15)01587-01588. doi: 10.1016/j.athoracsur.2015.09.079.[Epub ahead of print].
21. Zatevakhin Ⅱ, Pasechnik IN, Gubaidullin RR, et al. Accelerated postoperative rehabilitation: multidisciplinary issue (Part 1). Khirurgiia (Mosk), 2015, 9: 4-8.
22. 马丹, 杨梅, 樊骏, 等. 胸腔镜肺叶切除术后引流管管径对患者舒适度影响的前瞻性队列研究. 中国胸心血管外科临床杂志, 2015, 22(10): 928-931.
23. 鲍珊, 苏建华, 廖虎, 等. 合并慢性阻塞性肺病和手术方式对肺癌患者术后快速康复及治疗费用的影响. 中国胸心血管外科临床杂志, 2014, 21(1): 17-20.
24. 宋志芳, 韩兆杰, 林琳, 等. SF-36量表评价胸外科住院患者生活质量的信度和效度.中国胸心血管外科临床杂志, 2014, 21(2): 164-167.
25. Fagundes CP, Shi Q, Vaporciyan AA, et al. Symptom recovery after thoracic surgery: Measuring patient-reported outcomes with the MD Anderson Symptom Inventory. J Thorac Cardiovasc Surg, 2015, 150(3):613-619.
26. 周渝斌, 刘伦旭, 喻鹏铭, 等. 胸腔镜肺叶切除术后心肺功能的快速康复. 中国胸心血管外科临床杂志, 2013, 20(2): 168-171.
27. Hübner M, Addor V, Slieker J, et al. The impact of an enhanced recovery pathway on nursing workload: A retrospective cohort study. Int J Surg, 2015, 24(Pt A): 45-50.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Enhanced Lung Rehabilitation after Surgery: Peri-operative Processes Optimization Is Necessary

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