Effects of fine management on patients undergoing video-assisted thoracoscopic surgery for pulmonary nodule in day surgery mode_West China Medical Journal

Authors：

ZHANG Li ¹ , LIU Yang ² , HUANG Mingjun ¹ ,  DAI Yan ¹ , JIANG Lisha ² , CHE Guowei ³

1. Day Surgery Center, West China Hospital, Sichuan University / West China School of Nursing, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. Day Surgery Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
3. Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

DAI Yan, Email: 1846703501@qq.com

Keywords：

Video-assisted thoracoscopic surgery; Pulmonary nodule; Day surgery; Fine management

DOI：

10.7507/1002-0179.202012278

Video：

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Objective To explore the effect of perioperative fine management on patients undergoing video-assisted thoracoscopic surgery (VATS) for pulmonary nodule in day surgery mode.Methods We retrospectively analyzed the data of patients undergoing VATS for pulmonary nodule in Day Surgery Center of West China Hospital, Sichuan University between June 2019 and October 2020. The number of VATS procedures and general data of patients were collected. The effects of fine management on postoperative intrathoracic drain management, pain management, and diet management, as well as the postoperative follow-up and satisfaction survey were analyzed.Results A total of 162 patients were enrolled. The duration of postoperative chest drainage of 150 VATS patients who discharged from the hospital with normal extubation lasted for 5 to 22 h with an average of (10.88±3.54) h. Univariate analyses and multivariate logistic regression analysis showed that gender, age, method of surgery, and immediate postoperative pain score were not associated with delayed removal of thoracic drainage tube (>10 h) (P>0.05). The lowest score of numerical rating scale for pain intensity was 0 (painless) and the highest was 4 (moderate pain). After surgery, 12 patients (7.4%) were transferred out of the day surgery department, 2 patients (1.2%) were indwelled postoperative urinary catheter, 11 patients (6.8%) had unplanned revisit, and 6 patients (3.7%) had unplanned readmission. Patient satisfaction surveys were all satisfactory.Conclusions The implementation of fine management in VATS for pulmonary nodule in day surgery mode is beneficial for ensuring that patients can remove the drainage tube before discharge from the hospital, without severe pain after the operation and with good follow-up satisfaction.

Citation： ZHANG Li, LIU Yang, HUANG Mingjun, DAI Yan, JIANG Lisha, CHE Guowei. Effects of fine management on patients undergoing video-assisted thoracoscopic surgery for pulmonary nodule in day surgery mode. West China Medical Journal, 2021, 36(2): 183-189. doi: 10.7507/1002-0179.202012278 Copy

1.	郑荣寿, 孙可欣, 张思维, 等. 2015年中国恶性肿瘤流行情况分析. 中华肿瘤杂志, 2019, 41(1): 19-28.
2.	Hung MH, Chen JS, Cheng YJ. Precise anesthesia in thoracoscopic operations. Curr Opin Anaesthesiol, 2019, 32(1): 39-43.
3.	Tsubokawa N, Harada H, Takenaka C, et al. Comparison of postoperative pain after different thoracic surgery approaches as measured by electrical stimulation. Thorac Cardiovasc Surg, 2015, 63(6): 519-525.
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5.	Martin-Ucar AE, Nakas A, Pilling JE, et al. A case-matched study of anatomical segmentectomy versus lobectomy for stage I lung cancer in high-risk patients. Eur J Cardiothorac Surg, 2005, 27(4): 675-679.
6.	Ghaly G, Kamel M, Nasar A, et al. Video-assisted thoracoscopic surgery is a safe and effective alternative to thoracotomy for anatomical segmentectomy in patients with clinical stage I non-small cell lung cancer. Ann Thorac Surg, 2016, 101(2): 465-472; discussion 472.
7.	Lex JR, Naidu B. In patients with resectable non-small-cell lung cancer, is video-assisted thoracoscopic segmentectomy an appropriate alternative to video-assisted thoracoscopic lobectomy?. Interact Cardiovasc Thorac Surg, 2016, 23(5): 826-831.
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9.	汪晖. 精细化管理促进护理专业团队建设. 中国护理管理, 2015, 15(8): 905-907.
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11.	蒋丽莎, 谢晓兰, 戴燕, 等. 四川大学华西医院日间手术入院前管理规范. 华西医学, 2019, 34(2): 133-136.
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13.	董映显, 朱道君, 车国卫, 等. 肺癌日间手术操作流程与临床应用效果分析. 中国肺癌杂志, 2020, 23(2): 77-83.
14.	Chung F, Chan VW, Ong D. A post-anesthetic discharge scoring system for home readiness after ambulatory surgery. J Clin Anesth, 1995, 7(6): 500-506.
15.	苏纯音, 陆志华, 易利华, 等. 精细化管理在临床护理路径中的应用. 中华现代护理杂志, 2014, 20(17): 2136-2138.
16.	陈文龙. 创建节约型医院推进精细化管理. 现代医院管理, 2010, 8(1): 30-31.
17.	韩兆杰, 宋志芳, 苏建华, 等. 单胸腔引流管在肺癌术后快速康复中的应用. 中国胸心血管外科临床杂志, 2014, 21(1): 7-10.
18.	陈相军, 宋应寒, 陈敏, 等. 四川大学华西医院日间手术质量和安全管理规范. 华西医学, 2019, 34(2): 155-158.
19.	车国卫. 加速康复外科: 肺癌手术日间化现状与策略. 中国肺癌杂志, 2020, 23(1): 1-4.
20.	杨霞, 冯梅, 朱晶, 等. 一次性尿管用于胸腔镜下肺叶切除术后胸腔闭式引流的临床研究. 重庆医学, 2018, 47(22): 2986-2988.
21.	周景海, 李坤, 李彦宁, 等. 肺癌、食管癌切除术后胸腔闭式引流管拔除时机的随机对照研究. 中国胸心血管外科临床杂志, 2019, 26(9): 853-857.
22.	吴砚铭, 王彦, 周坤, 等. 肺癌患者术后胸腔引流管拔除时机及临床效果分析. 加速康复外科杂志, 2019, 2(4): 165-170.
23.	刘洋, 张一敏, 王小成, 等. 四川大学华西医院日间手术出院后管理规范. 华西医学, 2019, 34(2): 137-139.

1. 郑荣寿, 孙可欣, 张思维, 等. 2015年中国恶性肿瘤流行情况分析. 中华肿瘤杂志, 2019, 41(1): 19-28.
2. Hung MH, Chen JS, Cheng YJ. Precise anesthesia in thoracoscopic operations. Curr Opin Anaesthesiol, 2019, 32(1): 39-43.
3. Tsubokawa N, Harada H, Takenaka C, et al. Comparison of postoperative pain after different thoracic surgery approaches as measured by electrical stimulation. Thorac Cardiovasc Surg, 2015, 63(6): 519-525.
4. Veit S. Pain management in video-assisted thoracic surgery (VATS). Zentralbl Chir, 2014, 139(Suppl 1): S34-S38.
5. Martin-Ucar AE, Nakas A, Pilling JE, et al. A case-matched study of anatomical segmentectomy versus lobectomy for stage I lung cancer in high-risk patients. Eur J Cardiothorac Surg, 2005, 27(4): 675-679.
6. Ghaly G, Kamel M, Nasar A, et al. Video-assisted thoracoscopic surgery is a safe and effective alternative to thoracotomy for anatomical segmentectomy in patients with clinical stage I non-small cell lung cancer. Ann Thorac Surg, 2016, 101(2): 465-472; discussion 472.
7. Lex JR, Naidu B. In patients with resectable non-small-cell lung cancer, is video-assisted thoracoscopic segmentectomy an appropriate alternative to video-assisted thoracoscopic lobectomy?. Interact Cardiovasc Thorac Surg, 2016, 23(5): 826-831.
8. Agustoni F, Hirsch FR. PACIFIC trial: new perspectives for immunotherapy in lung cancer. Transl Lung Cancer Res, 2018, 7(Suppl 1): S19-S24.
9. 汪晖. 精细化管理促进护理专业团队建设. 中国护理管理, 2015, 15(8): 905-907.
10. 中华医学会呼吸病学分会肺癌学组, 中国肺癌防治联盟专家组. 肺结节诊治中国专家共识(2018 年版). 中华结核和呼吸杂志, 2018, 41(10): 763-771.
11. 蒋丽莎, 谢晓兰, 戴燕, 等. 四川大学华西医院日间手术入院前管理规范. 华西医学, 2019, 34(2): 133-136.
12. Karcioglu O, Topacoglu H, Dikme O, et al. A systematic review of the pain scales in adults: which to use?. Am J Emerg Med, 2018, 36(4): 707-714.
13. 董映显, 朱道君, 车国卫, 等. 肺癌日间手术操作流程与临床应用效果分析. 中国肺癌杂志, 2020, 23(2): 77-83.
14. Chung F, Chan VW, Ong D. A post-anesthetic discharge scoring system for home readiness after ambulatory surgery. J Clin Anesth, 1995, 7(6): 500-506.
15. 苏纯音, 陆志华, 易利华, 等. 精细化管理在临床护理路径中的应用. 中华现代护理杂志, 2014, 20(17): 2136-2138.
16. 陈文龙. 创建节约型医院推进精细化管理. 现代医院管理, 2010, 8(1): 30-31.
17. 韩兆杰, 宋志芳, 苏建华, 等. 单胸腔引流管在肺癌术后快速康复中的应用. 中国胸心血管外科临床杂志, 2014, 21(1): 7-10.
18. 陈相军, 宋应寒, 陈敏, 等. 四川大学华西医院日间手术质量和安全管理规范. 华西医学, 2019, 34(2): 155-158.
19. 车国卫. 加速康复外科: 肺癌手术日间化现状与策略. 中国肺癌杂志, 2020, 23(1): 1-4.
20. 杨霞, 冯梅, 朱晶, 等. 一次性尿管用于胸腔镜下肺叶切除术后胸腔闭式引流的临床研究. 重庆医学, 2018, 47(22): 2986-2988.
21. 周景海, 李坤, 李彦宁, 等. 肺癌、食管癌切除术后胸腔闭式引流管拔除时机的随机对照研究. 中国胸心血管外科临床杂志, 2019, 26(9): 853-857.
22. 吴砚铭, 王彦, 周坤, 等. 肺癌患者术后胸腔引流管拔除时机及临床效果分析. 加速康复外科杂志, 2019, 2(4): 165-170.
23. 刘洋, 张一敏, 王小成, 等. 四川大学华西医院日间手术出院后管理规范. 华西医学, 2019, 34(2): 137-139.

West China Medical Journal

Effects of fine management on patients undergoing video-assisted thoracoscopic surgery for pulmonary nodule in day surgery mode

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