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.	鄭榮壽, 孫可欣, 張思維, 等. 2015年中國惡性腫瘤流行情況分析. 中華腫瘤雜志, 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.
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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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11.	蔣麗莎, 謝曉蘭, 戴燕, 等. 四川大學華西醫院日間手術入院前管理規范. 華西醫學, 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.	董映顯, 朱道君, 車國衛, 等. 肺癌日間手術操作流程與臨床應用效果分析. 中國肺癌雜志, 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.	蘇純音, 陸志華, 易利華, 等. 精細化管理在臨床護理路徑中的應用. 中華現代護理雜志, 2014, 20(17): 2136-2138.
16.	陳文龍. 創建節約型醫院推進精細化管理. 現代醫院管理, 2010, 8(1): 30-31.
17.	韓兆杰, 宋志芳, 蘇建華, 等. 單胸腔引流管在肺癌術后快速康復中的應用. 中國胸心血管外科臨床雜志, 2014, 21(1): 7-10.
18.	陳相軍, 宋應寒, 陳敏, 等. 四川大學華西醫院日間手術質量和安全管理規范. 華西醫學, 2019, 34(2): 155-158.
19.	車國衛. 加速康復外科: 肺癌手術日間化現狀與策略. 中國肺癌雜志, 2020, 23(1): 1-4.
20.	楊霞, 馮梅, 朱晶, 等. 一次性尿管用于胸腔鏡下肺葉切除術后胸腔閉式引流的臨床研究. 重慶醫學, 2018, 47(22): 2986-2988.
21.	周景海, 李坤, 李彥寧, 等. 肺癌、食管癌切除術后胸腔閉式引流管拔除時機的隨機對照研究. 中國胸心血管外科臨床雜志, 2019, 26(9): 853-857.
22.	吳硯銘, 王彥, 周坤, 等. 肺癌患者術后胸腔引流管拔除時機及臨床效果分析. 加速康復外科雜志, 2019, 2(4): 165-170.
23.	劉洋, 張一敏, 王小成, 等. 四川大學華西醫院日間手術出院后管理規范. 華西醫學, 2019, 34(2): 137-139.

1. 鄭榮壽, 孫可欣, 張思維, 等. 2015年中國惡性腫瘤流行情況分析. 中華腫瘤雜志, 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. 汪暉. 精細化管理促進護理專業團隊建設. 中國護理管理, 2015, 15(8): 905-907.
10. 中華醫學會呼吸病學分會肺癌學組, 中國肺癌防治聯盟專家組. 肺結節診治中國專家共識(2018 年版). 中華結核和呼吸雜志, 2018, 41(10): 763-771.
11. 蔣麗莎, 謝曉蘭, 戴燕, 等. 四川大學華西醫院日間手術入院前管理規范. 華西醫學, 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. 董映顯, 朱道君, 車國衛, 等. 肺癌日間手術操作流程與臨床應用效果分析. 中國肺癌雜志, 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. 蘇純音, 陸志華, 易利華, 等. 精細化管理在臨床護理路徑中的應用. 中華現代護理雜志, 2014, 20(17): 2136-2138.
16. 陳文龍. 創建節約型醫院推進精細化管理. 現代醫院管理, 2010, 8(1): 30-31.
17. 韓兆杰, 宋志芳, 蘇建華, 等. 單胸腔引流管在肺癌術后快速康復中的應用. 中國胸心血管外科臨床雜志, 2014, 21(1): 7-10.
18. 陳相軍, 宋應寒, 陳敏, 等. 四川大學華西醫院日間手術質量和安全管理規范. 華西醫學, 2019, 34(2): 155-158.
19. 車國衛. 加速康復外科: 肺癌手術日間化現狀與策略. 中國肺癌雜志, 2020, 23(1): 1-4.
20. 楊霞, 馮梅, 朱晶, 等. 一次性尿管用于胸腔鏡下肺葉切除術后胸腔閉式引流的臨床研究. 重慶醫學, 2018, 47(22): 2986-2988.
21. 周景海, 李坤, 李彥寧, 等. 肺癌、食管癌切除術后胸腔閉式引流管拔除時機的隨機對照研究. 中國胸心血管外科臨床雜志, 2019, 26(9): 853-857.
22. 吳硯銘, 王彥, 周坤, 等. 肺癌患者術后胸腔引流管拔除時機及臨床效果分析. 加速康復外科雜志, 2019, 2(4): 165-170.
23. 劉洋, 張一敏, 王小成, 等. 四川大學華西醫院日間手術出院后管理規范. 華西醫學, 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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