Can postoperative complications be reduced by the application of ERAS protocols in operated non-small cell lung cancer patients?


TURNA A., ÖZÇIBIK G., FİDAN M. E., SARBAY İ., Kılıç B., KARA H. V., ...Daha Fazla

Türk Göğüs Kalp Damar Cerrahisi Dergisi, cilt.31, sa.2, ss.256-268, 2023 (SCI-Expanded, Scopus, TRDizin) identifier identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 31 Sayı: 2
  • Basım Tarihi: 2023
  • Doi Numarası: 10.5606/tgkdc.dergisi.2023.23514
  • Dergi Adı: Türk Göğüs Kalp Damar Cerrahisi Dergisi
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, TR DİZİN (ULAKBİM)
  • Sayfa Sayıları: ss.256-268
  • İstanbul Üniversitesi-Cerrahpaşa Adresli: Evet

Özet

Background: In our study, we aimed to evaluate the length of hospital stay and complication rate of patients before and after application of the Enhanced Recovery After Surgery (ERAS) protocols. Methods: Between January 2001 and January 2021, a total of 845 patients (687 males, 158 females; mean age: 55±11 years; range, 19 to 89 years) who were operated with the diagnosis of non-small cell lung carcinoma were retrospectively analyzed. The patients were divided into three groups as follows: patients between 2001 and 2010 were evaluated as pre-ERAS (Group 1, n=285), patients between 2011 and 2015 as preparation for ERAS period (Group 2, n=269), and patients who had resection between 2016 and 2021 as the ERAS period (Group 3, n=291). Results: All three groups were similar in terms of clinical, surgical and demographic characteristics. Smoking history was statistically significantly less in Group 3 (p=0.005). The forced expiratory volume in 1 sec/forced vital capacity and albumin levels were statistically significantly higher in Group 3 (p<0.001 and p=0.019, respectively). The leukocyte count and tumor maximum standardized uptake value were statistically significantly higher in Group 1 (p=0.018 and p=0.014, respectively). Postoperative hospitalization day, complication rate, and intensive care hospitalization rates were statistically significantly lower in Group 3 (p<0.001). The rate of additional disease was statistically significantly higher in Group 1 (p=0.030). Albumin level (<2.8 g/dL), lymphocyte/monocyte ratio (<1.35), and hemoglobin level (<8.3 g/dL) were found to be significant predictors of complication development. Conclusion: With the application of ERAS protocols, length of postoperative hospital stay, complication rate, and the need for intensive care hospitalization decrease. Preoperative hemoglobin level, albumin level, and lymphocyte/monocyte ratio are the predictors of complication development. Increasing hemoglobin and albumin levels before operation may reduce postoperative complications.