دورية أكاديمية
أعرض في EDS

Rapid Discharge After Anatomic Lung Resection: Is Ambulatory Surgery for Early Lung Cancer Possible?

التفاصيل البيبلوغرافية
العنوان: Rapid Discharge After Anatomic Lung Resection: Is Ambulatory Surgery for Early Lung Cancer Possible?
المؤلفون: Dolan DP; Department of Surgery, Surgical Outcomes and Quality Improvement Center, Northwestern Memorial Hospital, Chicago, Illinois; Northwestern University Feinberg School of Medicine, Chicago, Illinois; Canning Thoracic Institute, Northwestern Memorial Hospital, Chicago, Illinois., Visa M; Department of Surgery, Surgical Outcomes and Quality Improvement Center, Northwestern Memorial Hospital, Chicago, Illinois; Northwestern University Feinberg School of Medicine, Chicago, Illinois; Canning Thoracic Institute, Northwestern Memorial Hospital, Chicago, Illinois., Lee D; Department of Surgery, Surgical Outcomes and Quality Improvement Center, Northwestern Memorial Hospital, Chicago, Illinois; Northwestern University Feinberg School of Medicine, Chicago, Illinois; Canning Thoracic Institute, Northwestern Memorial Hospital, Chicago, Illinois., Lung KC; Department of Surgery, Surgical Outcomes and Quality Improvement Center, Northwestern Memorial Hospital, Chicago, Illinois; Northwestern University Feinberg School of Medicine, Chicago, Illinois; Canning Thoracic Institute, Northwestern Memorial Hospital, Chicago, Illinois., Patino DA; Department of Surgery, Surgical Outcomes and Quality Improvement Center, Northwestern Memorial Hospital, Chicago, Illinois; Northwestern University Feinberg School of Medicine, Chicago, Illinois; Canning Thoracic Institute, Northwestern Memorial Hospital, Chicago, Illinois., Kurihara C; Department of Surgery, Surgical Outcomes and Quality Improvement Center, Northwestern Memorial Hospital, Chicago, Illinois; Northwestern University Feinberg School of Medicine, Chicago, Illinois; Canning Thoracic Institute, Northwestern Memorial Hospital, Chicago, Illinois., Garza-Castillon R Jr; Department of Surgery, Surgical Outcomes and Quality Improvement Center, Northwestern Memorial Hospital, Chicago, Illinois; Northwestern University Feinberg School of Medicine, Chicago, Illinois; Canning Thoracic Institute, Northwestern Memorial Hospital, Chicago, Illinois., Odell DD; Department of Surgery, Surgical Outcomes and Quality Improvement Center, Northwestern Memorial Hospital, Chicago, Illinois; Northwestern University Feinberg School of Medicine, Chicago, Illinois; Canning Thoracic Institute, Northwestern Memorial Hospital, Chicago, Illinois., Bharat A; Department of Surgery, Surgical Outcomes and Quality Improvement Center, Northwestern Memorial Hospital, Chicago, Illinois; Northwestern University Feinberg School of Medicine, Chicago, Illinois; Canning Thoracic Institute, Northwestern Memorial Hospital, Chicago, Illinois., Kim S; Department of Surgery, Surgical Outcomes and Quality Improvement Center, Northwestern Memorial Hospital, Chicago, Illinois; Northwestern University Feinberg School of Medicine, Chicago, Illinois; Canning Thoracic Institute, Northwestern Memorial Hospital, Chicago, Illinois. Electronic address: samuel.kim2@nm.org.
المصدر: The Annals of thoracic surgery [Ann Thorac Surg] 2024 Feb; Vol. 117 (2), pp. 297-303. Date of Electronic Publication: 2023 Aug 15.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Elsevier Country of Publication: Netherlands NLM ID: 15030100R Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1552-6259 (Electronic) Linking ISSN: 00034975 NLM ISO Abbreviation: Ann Thorac Surg Subsets: MEDLINE
أسماء مطبوعة: Publication: Amsterdam : Elsevier
Original Publication: Boston.
مواضيع طبية MeSH: Lung Neoplasms*/pathology , Carcinoma, Non-Small-Cell Lung*/surgery , Carcinoma, Non-Small-Cell Lung*/etiology, Humans ; Patient Discharge ; Ambulatory Surgical Procedures ; Pneumonectomy/adverse effects ; Lung/surgery ; Retrospective Studies
مستخلص: Background: Given resource constraints during the coronavirus disease 2019 pandemic, we explored whether minimally invasive anatomic lung resections for early-stage lung cancer could undergo rapid discharge.
Methods: All patients with clinical stage I-II non-small cell lung cancer from September 2019 to June 2022 who underwent minimally invasive anatomic lung resection at a single institution were included. Patients discharged without a chest tube <18 hours after operation, meeting preset criteria, were considered rapid discharge. Demographics, comorbidities, operative details, and 30-day outcomes were compared between rapid discharge patients and nonrapid discharge "control" patients. Multivariable logistic regression was performed for predictors of nonrapid discharge.
Results: Overall, 430 patients underwent resection (200 lobectomies and 230 segmentectomies); 162 patients (37%) underwent rapid discharge and 268 patients (63%) were controls. The rapid discharge group was younger (66.5 vs 70.0 years; P < .001), was assigned to lower American Society of Anesthesiologists class (P = .02), had more segmentectomies than lobectomies (P = .003), and had smaller tumors (P < .001). There were no differences between groups in distance from home to hospital (P = .335) or readmission rates (P = .39). Increasing age had higher odds for nonrapid discharge (odds ratio, 1.04; 95% CI, 1.02-1.07), whereas segmentectomy had decreased odds (odds ratio, 0.46; 95% CI, 0.28-0.75).
Conclusions: Approximately 37% of the patients underwent rapid discharge after operation with similar readmission rate to controls. Increasing age had higher odds for nonrapid discharge; segmentectomy was likely to lead to rapid discharge. Consideration of rapid discharge minimally invasive lung resection for early-stage lung cancer can result in significant reduction in inpatient resources without adverse patient outcomes.
(Copyright © 2024 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.)
تواريخ الأحداث: Date Created: 20230816 Date Completed: 20240115 Latest Revision: 20240115
رمز التحديث: 20240115
DOI: 10.1016/j.athoracsur.2023.07.046
PMID: 37586584
قاعدة البيانات: MEDLINE
الوصف
تدمد:1552-6259
DOI:10.1016/j.athoracsur.2023.07.046