Discharging Patients by Postoperative Day One After Robotic Anatomic Pulmonary Resection

Geraci, Travis C.; Chang, Stephanie H.; Chen, Stacey; Ferrari-Light, Dana; Cerfolio, Robert J.

doi:10.1016/j.athoracsur.2021.06.088

Cited by 18 publications

(13 citation statements)

References 14 publications

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“…All studies were conducted in the US and published in or after 2018. Six out of eight studies analyzed data from an existing multicentric database [ 14 , 16 , 18 , 21 , 27 , 28 ], while the remaining two [ 15 , 22 ] used institutional data. Two of the included studies performed propensity-score-matched analyses [ 14 , 18 ].…”

Section: Resultsmentioning

confidence: 99%

Factors associated with safe and successful postoperative day 1 discharge after lung operations: a systematic review and meta-analysis

Martins,

Fatimi,

Ansari

et al. 2024

J Cardiothorac Surg

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Background A shorter length of stay (LOS) is associated with fewer hospital-acquired adverse conditions and decreased utilization of hospital resources. While modern perioperative care protocols have enabled some ambitious surgical teams to achieve discharge as early as within postoperative day 1 (POD1), most other teams remain cautious about such an approach due to the perceived risk of missing postoperative complications and increased readmission rates. We aimed to identify factors that would help guide surgical teams aiming for safe and successful POD1 discharge after lung resection. Methods We searched the PubMed, Embase, Scopus, Web of Science and CENTRAL databases for articles comparing perioperative characteristics in patients discharged within POD1 (DWPOD1) and after POD1 (DAPOD1) following lung resection. Meta-analysis was performed using a random-effects model. Results We included eight retrospective cohort studies with a total of 216,887 patients, of which 22,250 (10.3%) patients were DWPOD1. Our meta-analysis showed that younger patients, those without cardiovascular and respiratory comorbidities, and those with better preoperative pulmonary function are more likely to qualify for DWPOD1. Certain operative factors, such as a minimally invasive approach, shorter operations, and sublobar resections, also favor DWPOD1. DWPOD1 appears to be safe, with comparable 30-day mortality and readmission rates, and significantly less postoperative morbidity than DAPOD1. Conclusions In select patients with a favorable preoperative profile, DWPOD1 after lung resection can be achieved successfully and without increased risk of adverse outcomes such as postoperative morbidity, mortality, or readmissions.

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Section: Resultsmentioning

confidence: 99%

Factors associated with safe and successful postoperative day 1 discharge after lung operations: a systematic review and meta-analysis

Martins,

Fatimi,

Ansari

et al. 2024

J Cardiothorac Surg

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“…One of the direct benefits our research highlights is the reduction in hospital days, which decreases the overall cost of robotic surgery. The most experienced centers are showing a progressive decrease in the number of days of stay [ 30 ], so we believe that this is a parameter to be considered in the economic calculations when investing in the implementation of this technology. Along these lines, a recent study by Harrison et al concluded that completion of the learning curve was linked to a significant reduction in operating room costs associated with RATS lung resection and was comparable to the cost of VATS [ 31 ].…”

Section: Discussionmentioning

confidence: 99%

Robotic Lobectomy Learning Curve Has Better Clinical Outcomes than Videothoracoscopic Lobectomy

Paglialunga,

Molins,

Guzmán

et al. 2024

JCM

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Introduction: The robotic-assisted (RATS) lobectomy learning curve is usually measured compared to an established videothoracoscopic (VATS) surgery program. The objective of our study is to compare the learning curves of both techniques. Methods: We performed an intention-to-treat analysis comparing the RATS vs. VATS lobectomies. Surgical time, conversions, complications, number of lymph nodes (LNs) and lymph node stations harvested, chest drainage duration, length of stay, readmissions, and 90-day mortality were compared between both groups. The learning curve was assessed using the CUSUM method. Results: RATS cases (30) and VATS cases (35) displayed no significant differences. The RATS learning curve was completed after 23 procedures while the VATS curve required 28 interventions. Complications appeared in four RATS procedures and in eight VATS patients. No differences in the number of LNs and harvested LN stations were reported. Four patients were readmitted in the RATS group, and eight in the VATS group. No 90-day postoperative mortality was observed in either group. The RATS group reported fewer chest tube days (3 (2–5) vs. 5 (4–5.8), p = 0.005) and hospital days (4 (3–6) vs. 5 (4–6), p = 0.023). Conclusions: The RATS curve appears shorter than the VATS curve. RATS lobectomies resulted in reduced chest tube duration and length of stay during the learning time period.

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“…Patients were given ice-cream in the recovery room to rule out a chylothorax to facilitate early chest tube removal. The authors showed that it is feasible and safe to discharge patients on post-operative day 1 (50). Overall, this was achieved in 53% (134/253) of the patients and it reached 97% (28/29) and 68% (23/34) during the last quartile of the study for segmentectomy and lobectomy respectively.…”

Section: Early Chest Drain Removal In Roboticassisted Lung Resectionmentioning

confidence: 93%

Editorial: Early chest drain removal following lung resection

et al. 2023

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Discharging Patients by Postoperative Day One After Robotic Anatomic Pulmonary Resection

Cited by 18 publications

References 14 publications

Factors associated with safe and successful postoperative day 1 discharge after lung operations: a systematic review and meta-analysis

Factors associated with safe and successful postoperative day 1 discharge after lung operations: a systematic review and meta-analysis

Robotic Lobectomy Learning Curve Has Better Clinical Outcomes than Videothoracoscopic Lobectomy

Editorial: Early chest drain removal following lung resection

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