Outcomes after implementing the enhanced recovery after surgery protocol for patients undergoing tuberculous empyema operations

Abstract

Background: Enhanced recovery after surgery (ERAS) protocols provide recommendations for care in various surgical fields. However, there is scarce information on the application of these protocols in tuberculous empyema surgery. The purpose of this research is to evaluate the outcomes of ERAS recommendations for patients who received tuberculous empyema surgery. Methods: A retrospective analysis was performed on patients who underwent tuberculous empyema surgery in our hospital from March 2011 to March 2016. The patients were divided into an ERAS group and a conventional control group. The main outcome measure was the postoperative median length of stay (including readmissions). Principles related to ERAS were documented, and the postoperative median hospital stay was analyzed statistically between the two groups. Results: A total of 92 patients underwent 93 consecutive tuberculous empyema surgical treatments. The postoperative fasting time, chest tube duration, and length of stay were shorter in the ERAS group compared with the control group. The volume of chest tube drainage in the ERAS group was significantly smaller than that of the control group. No statistical differences were observed in the postoperative complications and reasons for readmission between the two groups. Conclusions: Application of ERAS recommendations in patients receiving tuberculous empyema operations decreased the length of stay and chest tube drainage compared to the control group. Enhanced recovery after surgery (ERAS) protocols are currently applied for the care for subjects undergoing lung resection surgery (2). High-rank evidence retains to sustain their applications (3). ERAS involves preoperative optimization, minimization of preoperative fasting, and normal physiological restoration. However, there is relatively scarce data on the application of ERAS protocols in patients undergoing tuberculous empyema operations. Nevertheless, further studies are needed to identify differences in these specific outcomes. In addition, no investigations have yet evaluated the effect of ERAS protocols on quality of life outcomes (4). Moreover, a previous report noted heterogeneity in the characterizations of ERAS programs (5).Real-time clinical practice usually incorporates advancements over time as new evidence becomes available. Therefore, the purpose of this study was to evaluate the recommendations of an ERAS program for tuberculous empyema patients undergoing VATS. The study was conducted over a 5-year period to determine whether the introduction of ERAS protocols shortens the length of hospital stay for patients and improves their quality of life. Methods Subject enrollmentAll subjects were diagnosed with tuberculous empyema based on the following criteria: patients exhibited fever, emaciation, fatigue, chest pain, cough, and shortness of breath with a history of tuberculosis pleurisy. Local chest percussion demonstrated dullness or flatness, and auscultation indicated that breath sounds were absent or diminished. Thoracentesis obtained str...

Does an enhanced recovery after surgery protocol affect perioperative surgical outcomes in stage III tubercular empyema? A comparative analysis of 243 patients

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Evaluation of thoracic surgery as a treatment approach in patients with rifampin-resistant chronic tuberculous empyema

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