BAOShan 1 , SUJian-hua 2 , LIAOHu 1 , LIULun-xu 1 , CHEGuo-wei 1
  • 1. Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;
  • 2. Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;
CHEGuo-wei, Email: guowei_che@yahoo.com
Video-assisted thoracoscopic surgery lobectomy; Chronic obstructive pulmonary disease; Fast track recovery; Lung caner
10.7507/1007-4848.20140006
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Objective To investigate the impact of chronic obstructive pulmonary disease (COPD) and surgical approach on postoperative fast track recovery and hospitalization cost of patients undergoing lung cancer resection, and explore clinical pathways and clinical value of fast track recovery. Method Clinical data of 129 consecutive patients undergoing lung cancer resection by one surgical group in West China Hospital from January 2010 to March 2011 were retrospectively analyzed. According to whether the patients had concomitant COPD, all the patients were divided into COPD group including 53 patients (39 males and 14 females) with their average age of 56.31±10.51 years, and non-COPD group including 76 patients (37 males and 39 females) with their average age of 65.92±7.85 years. According to different surgical approaches, all the patients were divided into complete video-assisted thoracoscopic surgery (VATS) group including 83 patients (44 males and 39 females) with their average age of 61.62±10.80 years, and routine thoracotomy group including 46 patients (32 males and 14 females) with their average age of 62.95±9.97 years. Postoperative morbidity, average hospital stay and hospitalization cost were compared between respective groups. Results There was no statistical difference in postoperative morbidity (53% vs. 40%, P=0.134)or average hospital stay[(7.66±2.95) days vs. (7.36±2.74)days, P=0.539] between COPD group and non-COPD group. Postoperative morbidity (34% vs. 65%, P < 0.001)and average hospital stay[(6.67±2.52)days vs. (8.61±3.01) days, P < 0.001] of VATS group were significantly lower or shorter than those of routine thoracotomy group. Total hospitalization cost (￥44 542.26±11 447.50 yuan vs. ￥23 634.13±6 014.35 yuan, P < 0.001) and material cost (￥37 352.53±11 807.81 yuan vs. ￥12 763.08±7 124.76 yuan, P < 0.001) of VATS group were significantly higher than those of routine thoracotomy group. Average medication cost of VATS group was significantly lower than that of routine thoracotomy group (￥7 473.54±4 523.70 vs. ￥10 176.71±6 371.12, P < 0.001). There was no statistical difference in other cost between VATS group and routine thoracotomy group. Conclusion VATS lobectomy can promote postoperative fast track recovery of lung cancer patients, but also increase material cost of the surgery. COPD history does not influence postoperative fast track recovery or hospitalization cost.

Citation： BAOShan, SUJian-hua, LIAOHu, LIULun-xu, CHEGuo-wei. Impact of Chronic Obstructive Pulmonary Disease and Surgical Approach on Postoperative Fast Track Recovery and Hospitalization Cost of Patients Undergoing Lung Cancer Resection. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2014, 21(1): 17-20. doi: 10.7507/1007-4848.20140006 Copy

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