Cancer Management and Research (Aug 2021)
Video-Assisted Thoracoscopic Day Surgery for Patients with Pulmonary Nodules: A Single-Center Clinical Experience of 200 Cases
Abstract
Yingxian Dong,1,* Jialong Li,1,* Junke Chang,1 Wenpeng Song,1 Yu Wang,2 Yan Wang,1 Guowei Che1 1Department of Thoracic Surgery, West-China Hospital, Sichuan University, Chengdu, 610041, People’s Republic of China; 2Day Surgery Center, West China Hospital, Sichuan University, Chengdu, 610041, People’s Republic of China*These authors contributed equally to this workCorrespondence: Guowei CheDepartment of Thoracic Surgery, West-China Hospital, Sichuan University, Chengdu, 610041, People’s Republic of ChinaTel/Fax +86-28-85422494Email [email protected]: We reviewed our experience with 200 patients who underwent video-assisted thoracoscopic day surgery (VATDS) at the Day Surgery Center at West China Hospital to identify the safety and feasibility of VATDS and assess the value of novel management in patients with pulmonary nodules.Methods: Between June 2019 and December 2020, 200 patients with pulmonary nodules underwent VATDS at the Day Surgery Center at West China Hospital. The medical records of these 200 patients were reviewed for age, sex, preoperative history, operative and pathological findings, amount of daily chest tube drainage, procedure method and duration, length of stay (LOS), visual analog scale (VAS), and postoperative pulmonary complications (PPCs).Results: There were 45 male and 155 female patients with a median age of 43 years (range 18 to 58 years). A total of 158 (79.00%) patients were diagnosed with lung adenocarcinoma, 35 (17.50%) were diagnosed with chronic inflammation with fibrous hyperplasia, and seven (3.50%) were diagnosed with granulomatous inflammation with necrosis. The mean LOS of the 200 patients was 1.25± 0.95 days, and 187 (93.50%) patients were discharged within 24 hours as planned. Thirteen patients were transferred to the thoracic surgery ward for further treatment because of PPCs. The median VAS was 3 points (range 1 to 7 points), and the rate of PPCs was 11.50%.Conclusion: Two hundred patients underwent VATDS with an acceptable 24-hour discharge rate. However, selection of patients for VATDS is required, and the implementation of VATDS on a larger scale requires further discussion.Keywords: video-assisted thoracoscopic surgery, day surgery, lung cancer, enhanced recovery after surgery
