[Application of Single-hole Thoracoscopic Surgery Combined with ERAS Concept for Respiratory Function Exercise in Perioperative Period of Lung Cancer]

Application Effect and Prognosis of High-Quality Nursing in the Whole Process of Nursing in Lung Cancer Surgery

Objective

To explore the application effect and prognostic benefits of whole-course high-quality nursing in lung cancer patients after surgery.

Methods

Sixty patients with lung cancer who underwent surgical treatment in the Department of Respiratory Medicine from April 2020 to July 2021 were recruited and assigned to receive either conventional nursing (control group) or whole-course high-quality nursing (intervention group) using the random number table method, with 30 cases in each group. Outcome measures included self-rating anxiety scale (SAS) scores, self-rating depression scale (SDS) scores, nursing compliance, patient satisfaction, complications, and patient prognosis.

Results

Patients receiving whole-course high-quality nursing showed significantly lower SAS and SDS scores versus those given conventional nursing (P < 0.05). Whole-course high-quality nursing resulted in higher patient compliance versus conventional nursing (P < 0.05). Patients in the intervention group were more satisfied with the nursing compared with those in the control group (P < 0.05). Whole-course high-quality nursing resulted in a lower incidence of complications, postoperative recurrence, and mortality versus conventional nursing (P < 0.05).

Conclusion

Whole-course high-quality nursing alleviates the negative emotions of patients after lung cancer surgery, enhances patient compliance and satisfaction, and reduces the incidence of postoperative relapse and complications, which demonstrates great potential for clinical promotion.

Complete Video-Assisted Thoracoscopic Surgery and Traditional Open Surgery for Elderly Patients With NSCLC

Objective:

To observe the efficacy of complete video-assisted thoracoscopic surgery (CVATS) and traditional open surgery (TOS) in the treatment of elderly patients with non-small cell lung cancer (NSCLC) and their influence on cardiopulmonary function.

Methods

A total of 120 elderly patients with primary NSCLC who were treated surgically in our hospital from January 2018 to January 2021 were selected and divided into the study group and the control group according to the different surgical procedures, 60 patients in each group. CVATS was used in the observation group and TOS in the control group. The surgical indexes and cardiopulmonary function indexes were observed and compared between the two groups. The serum C-reactive protein (CRP) level and visual analog scale's (VAS) score of the patients at different time points were detected. The incidence of postoperative complications was compared between the two groups.

Results

The perioperative indexes such as operation time were significantly different between the two groups (p < 0.05), but the number of lymph node dissection was not significantly different (p > 0.05). The serum CRP level and VAS score of the observation group were significantly lower than those of the control group on the 1st, 3rd, and 7th postoperative days (p < 0.05). There were significant differences in cardiopulmonary function between the two groups on the 7th postoperative day (p < 0.05). The incidence of adverse reactions in the observation group was significantly lower than that in the control group (p > 0.05).

Conclusion

CVATS is effective in the treatment of NSCLC. Compared with TOS therapy, CVATS has less damage to cardiopulmonary function and fewer complications, which is conducive to the rehabilitation of elderly patients. It is a safe and reliable scheme for the treatment of elderly patients with NSCLC.

Application value of goal-directed fluid therapy with ERAS in patients undergoing radical lung cancer surgery

OBJECTIVE

To explore the application value of goal-directed fluid therapy (GDFT) in the enhanced recovery after surgery (ERAS) of patients undergoing radical lung cancer surgery (RLCS).

METHODS

A total of 74 patients undergoing elective RLCS based on the enhance recovery after surgery (ERAS) concept in the HanDan Central Hospital between December 2016 and December 2019 were enrolled and assigned to a group treated by regular conventional liquids (regular group, n=34) and a group treated by goal-directed fluid (GDFT group, n=40) according to the fluid infusion scheme. The two groups were compared in intraoperative fluid inflow and outflow, hemodynamic indexes at 30 min (T0) before operation, 4 h (T1) and 24 h (T2) after operation, postoperative complications, postoperative recovery, inflammatory factors at 1 day (d 0) before operation, and at 1 day (d 1) and 7 days (d 3) after operation, as well as for postoperative life quality.

RESULTS

Crystalloid fluid input, fluid infusion, and urine output of the GDFT group were all significantly less than those of the regular group (all P<0.05), and the GDFT group showed significantly lower fluctuations of MAP, cardiac index, and stroke volume (SV) than the regular group (all P<0.05). Additionally, the GDFT group showed a significantly lower overall complication rate and experienced notably earlier time to flatus and getting out-of-bed time and notably shorter hospitalization time than the regular group (all P<0.05). Moreover, the GDFT group presented with less fluctuation of IL-10, IL-6, and TNF-α levels and experienced notably higher life quality scores than the regular group.

CONCLUSION

GDFT is beneficial to the rapid recovery of patients after RLCS, because it can exert a positive effect on maintaining the stability of hemodynamic indexes and reducing inflammation and postoperative complications.