Decreasing use of epidural analgesia with increasing minimally invasive lobectomy: Impact on postoperative morbidity. Academic Article uri icon

Overview

abstract

  • OBJECTIVE: The goal of this study is to investigate the use of EA and its impact on the postoperative short-term outcomes of patients with non-small cell lung cancer (NSCLC) who received a lobectomy by either minimally invasive surgery (MIS) or thoracotomy. MATERIALS AND METHODS: We investigated 793 patients who underwent lobectomy for pathological stage I-III NSCLC without induction therapy during two time periods, an early-time period (2009-2010: MIS, n = 204 [53%]; and thoracotomy, n = 182 [47%]) and a late-period (2014-2015: MIS, n = 308 [76%]; and thoracotomy, n = 99 [24%]). Patient characteristics, including pulmonary function tests, comorbidities, and use of EA, as well as short-term outcomes, including length of stay, morbidity, and mortality were assessed and compared between early-and late-time periods. We also compared patients who received EA (n = 150) with patients who did not receive EA (n = 158) following MIS lobectomy in the late-time period. RESULTS: The use of MIS lobectomy increased during the late-time period compared to the early-time period (p < 0.001). In patients who underwent MIS lobectomy, the use of EA significantly decreased in the late-time period compared to the early-time period (2009-2010 vs. 2014-2015, 95% vs. 51%; p < 0.001). There was no difference in postoperative morbidity and mortality between the two time periods in both MIS and thoracotomy. In the late-time period MIS group, the length of stay in the no EA group (n = 150) was shorter than that in the EA group (n = 158) (3 vs. 4 days, p = 0.038). There was no difference in morbidity and mortality between the EA and no EA groups. CONCLUSION: In our study cohort, the observed decrease in the use of EA with the increasing rate of MIS lobectomy did not negatively affect postoperative short-term outcomes.

publication date

  • November 11, 2019

Research

keywords

  • Analgesia, Epidural
  • Carcinoma, Non-Small-Cell Lung
  • Lung Neoplasms
  • Minimally Invasive Surgical Procedures
  • Pneumonectomy
  • Postoperative Complications
  • Thoracotomy

Identity

PubMed Central ID

  • PMC7171549

Scopus Document Identifier

  • 85074922013

Digital Object Identifier (DOI)

  • 10.1016/j.lungcan.2019.11.001

PubMed ID

  • 31743888

Additional Document Info

volume

  • 139