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Chinese Journal of Thoracic Surgery(Electronic Edition) ›› 2021, Vol. 08 ›› Issue (04): 229-234. doi: 10.3877/cma.j.issn.2095-8773.2021.04.05

• Original Article • Previous Articles     Next Articles

Application of accelerated rehabilitation surgical procedure in the perioperative period of single-port thoracoscopic lobectomy

Zhanliang Ren1, Xiaopeng Ren1,(), Yong Zhang1, Taiping He1, Yingjie Han1, Weifeng Zhang1, Yunhao Liu1, Mingliang Xing1   

  1. 1. Department of Cardiothoracic Surgery, Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine, Xianyang 712000, China
  • Received:2020-04-19 Revised:2021-08-20 Accepted:2021-08-30 Online:2021-11-28 Published:2021-12-14
  • Contact: Xiaopeng Ren

Abstract:

Objective

To explore the application and analysis of accelerated rehabilitation procedures in the perioperative period of single-port thoracoscopic lobectomy.

Methods

A review of 42 patients undergoing lung cancer surgery admitted to the Department of Thoracic and Cardiovascular Surgery in our hospital from January 2017 to June 2019 was performed. Single-port thoracoscopy combined with accelerated rehabilitation surgery was used in the perioperative period to optimize the processing model of the rehabilitation surgery process. The pain score, operation time after radical lung cancer surgery, intraoperative fluid replacement, chest drainage, chest tube indwelling time, average length of hospital stay, inflammatory indicators, and complications were analyzed.

Results

All patients underwent single-port thoracoscopic radical resection of lung cancer, and the perioperative period used accelerated rehabilitation surgery to optimize the treatment process. The operation time of patients was (167.53±53.86) min. The intraoperative fluid supplement was (696.20±148.49) mL. The morning pain scores at 24 h, 48 h and 72 h after surgery were 3.11±0.62, 3.27±0.48, 2.69±0.81, respectively. The total amount of postoperative chest suction was (627.38±76.35) mL, the chest suction volume was (141.07±35.22) mL when the chest guide tube was pulled out, and the chest tube removal time was (3.50±1.73) d. Postoperative hospitalization time was (7.16±1.58) d. On the first 1, 4, and 7 days after surgery, C-reactive protein levels were (49.20±17.48) mg/L, (31.66±17.30) mg/L, and (13.37±9.42) mg/L; white blood cells were (14.04±2.55) ×109/L, (10.17±1.25) ×109/L, and (7.71±0.83) ×109/L; the D-dimer test were (4.03±1.10) mg/L, (2.92±1.54) mg/L, and (1.79±1.14) mg/L. There were 2 cases of pulmonary infection with atelectasis, 2 cases of lung air leakage with subcutaneous emphysema, 3 cases of pleural effusion, 1 case of arrhythmia, and the total incidence of complications was 19.05% (8/42). Upon discharge from the hospital, there was no pneumothorax and obvious pleural effusion on chest CT, and no lung infection.

Conclusion

Publicity and education management, diet management, airway management, liquid management, anaesthesia management, pain management, pipe management, rehabilitation management and other accelerated rehabilitation surgical process management modes, which are used in lung cancer optimal combination and multi-mode management during the perioperative period, and the establishment of treatment measures that accelerate the rehabilitation of surgical procedures and single-port thoracoscopy technology can accelerate the rapid postoperative recovery.

Key words: Accelerated rehabilitation surgery, Single-port thoracoscopy, Lobectomy

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