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Ebrahimian S, Chervu N, Hadaya J, Cho NY, Kronen E, Sakowitz S, Verma A, Bakhtiyar SS, Sanaiha Y, Benharash P. National outcomes of expedited discharge following esophagectomy for malignancy. PLoS One 2024; 19:e0297470. [PMID: 38394104 PMCID: PMC10889881 DOI: 10.1371/journal.pone.0297470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 01/05/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Expedited discharge following esophagectomy is controversial due to concerns for higher readmissions and financial burden. The present study aimed to evaluate the association of expedited discharge with hospitalization costs and unplanned readmissions following esophagectomy for malignant lesions. METHODS Adults undergoing elective esophagectomy for cancer were identified in the 2014-2019 Nationwide Readmissions Database. Patients discharged by postoperative day 7 were considered Expedited and others as Routine. Patients who did not survive to discharge or had major perioperative complications were excluded. Multivariable regression models were constructed to assess association of expedited discharge with index hospitalization costs as well as 30- and 90-day non-elective readmissions. RESULTS Of 9,886 patients who met study criteria, 34.6% comprised the Expedited cohort. After adjustment, female sex (adjusted odds ratio [AOR] 0.71, p = 0.001) and increasing Elixhauser Comorbidity Index (AOR 0.88/point, p<0.001) were associated with lower odds of expedited discharge, while laparoscopic (AOR 1.63, p<0.001, Ref: open) and robotic (AOR 1.67, p = 0.003, Ref: open) approach were linked to greater likelihood. Patients at centers in the highest-tertile of minimally invasive esophagectomy volume had increased odds of expedited discharge (AOR 1.52, p = 0.025, Ref: lowest-tertile). On multivariable analysis, expedited discharge was independently associated with an $8,300 reduction in hospitalization costs. Notably, expedited discharge was associated with similar odds of 30-day (AOR 1.10, p = 0.40) and 90-day (AOR 0.90, p = 0.70) unplanned readmissions. CONCLUSION Expedited discharge after esophagectomy was associated with decreased costs and unaltered readmissions. Prospective studies are necessary to robustly evaluate whether expedited discharge is appropriate for select patients undergoing esophagectomy.
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Affiliation(s)
- Shayan Ebrahimian
- Cardiovascular Outcomes Research Laboratories, Division of Cardiothoracic Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States of America
| | - Nikhil Chervu
- Cardiovascular Outcomes Research Laboratories, Division of Cardiothoracic Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States of America
| | - Joseph Hadaya
- Cardiovascular Outcomes Research Laboratories, Division of Cardiothoracic Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States of America
| | - Nam Yong Cho
- Cardiovascular Outcomes Research Laboratories, Division of Cardiothoracic Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States of America
| | - Elsa Kronen
- Cardiovascular Outcomes Research Laboratories, Division of Cardiothoracic Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States of America
| | - Sara Sakowitz
- Cardiovascular Outcomes Research Laboratories, Division of Cardiothoracic Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States of America
| | - Arjun Verma
- Cardiovascular Outcomes Research Laboratories, Division of Cardiothoracic Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States of America
| | - Syed Shahyan Bakhtiyar
- Cardiovascular Outcomes Research Laboratories, Division of Cardiothoracic Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States of America
| | - Yas Sanaiha
- Cardiovascular Outcomes Research Laboratories, Division of Cardiothoracic Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States of America
- Department of Surgery, Division of Cardiac Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States of America
| | - Peyman Benharash
- Cardiovascular Outcomes Research Laboratories, Division of Cardiothoracic Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States of America
- Department of Surgery, Division of Cardiac Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States of America
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Ju X, Feng J, Yang J, Ge L, Liu X. Factors influencing the preoperative anxiety in lung cancer patients undergoing video-assisted thoracoscopic surgery: The role of information needs, illness perception and patient trust. J Psychosom Res 2023; 172:111374. [PMID: 37302380 DOI: 10.1016/j.jpsychores.2023.111374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 04/14/2023] [Accepted: 05/10/2023] [Indexed: 06/13/2023]
Abstract
OBJECTIVES This study aimed to investigate preoperative anxiety in patients with lung cancer scheduled for video-assisted thoracoscopic surgery (VATS) and explore the influence of demographic factors, information needs, illness perception, and patient trust in preoperative anxiety. METHODS This cross-sectional study was conducted at a tertiary referral center in China from August 14 to December 1, 2022. Patients with lung cancer (N = 308) scheduled for VATS were evaluated using the Amsterdam Anxiety and Information Scale (APAIS), Brief Illness Perception Questionnaire (BIPQ), and Wake Forest Physician Trust Scale (WFPTS). Multivariate linear regression was employed to determine the independent predictors of preoperative anxiety. RESULTS The average total APAIS anxiety score was (10.6 ± 4.2). Of the sample, 48.4% reported high preoperative anxiety (APAIS-A: ≥10). Multivariate linear regression analysis showed that preoperative anxiety was higher in women (B = 0.860); and that preoperative length of stay ≥24 h (B = 0.016), more information needs (B = 0.988), more severe illness perceptions (B = 0.101) and more patient trust (B = -0.078) may lead to higher preoperative anxiety levels. CONCLUSIONS Preoperative anxiety is common in patients with lung cancer scheduled for VATS. Therefore, more attention should be paid to women and patients with a preoperative length of stay of ≥24 h. Meeting information needs, transforming positive disease perceptions, and strengthening the doctor-patient trusting relationship are key protective factors for preoperative anxiety.
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Affiliation(s)
- Xinxing Ju
- Department of Thoracic Surgery, Shanghai Chest Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200030, China
| | - Jing Feng
- Department of Thoracic Surgery, Shanghai Chest Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200030, China
| | - Jie Yang
- Department of Day Surgery, Shanghai Chest Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200030, China
| | - Ling Ge
- Department of Day Surgery, Shanghai Chest Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200030, China
| | - Xiaoxin Liu
- Nursing Department, Shanghai Chest Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200030, China.
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Wang J, Deng N, Qi F, Li Q, Jin X, Hu H. The effectiveness of postoperative rehabilitation interventions that include breathing exercises to prevent pulmonary atelectasis in lung cancer resection patients: a systematic review and meta-analysis. BMC Pulm Med 2023; 23:276. [PMID: 37501067 PMCID: PMC10375623 DOI: 10.1186/s12890-023-02563-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 07/13/2023] [Indexed: 07/29/2023] Open
Abstract
BACKGROUND The main aim of this systematic review was to determine the effectiveness of postoperative rehabilitation interventions that include breathing exercises as a component to prevent atelectasis in lung cancer resection patients. METHODS In this review, we systematically and comprehensively searched the Cochrane Library, PubMed, EMBASE, and Web of Science in English and CNKI and Wanfang in Chinese from 2012 to 2022. The review included any randomized controlled trials focusing on the effectiveness of postoperative rehabilitation interventions that include breathing exercises to prevent pulmonary atelectasis in lung cancer patients. Participants who underwent anatomic pulmonary resection and received postoperative rehabilitation interventions that included breathing exercises as a component were included in this review. The study quality and risks of bias were measured with the GRADE and Cochrane Collaboration tools, and statistical analysis was performed utilizing RevMan 5.3 software. RESULTS The incidence of atelectasis was significantly lower in the postoperative rehabilitation intervention group (OR = 0.35; 95% CI, 0.18 to 0.67; I2 = 0%; P = 0.67) than in the control group. The patients who underwent the postoperative rehabilitation program that included breathing exercises (intervention group) had higher forced vital capacity (FVC) scores (MD = 0.24; 95% CI, 0.07 to 0.41; I2 = 73%; P = 0.02), forced expiratory volume in one second (FEV1) scores (MD = 0.31; 95% CI, 0.03 to 0.60; I2 = 98%; P < 0.01) and FEV1/FVC ratios (MD = 9.09; 95% CI, 1.50 to 16.67; I2 = 94%; P < 0.01). CONCLUSION Postoperative rehabilitation interventions that included breathing exercises decreased the incidence rate of atelectasis and improved lung function by increasing the FVC, FEV1, and FEV1/FVC ratio.
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Affiliation(s)
- Jun Wang
- Department of Rehabilitation Medicine, The Second Xiangya Hospital of Central South University, Renmin Road No. 139, Furong District, Changsha, 410000, Hunan, China
| | - Na Deng
- Department of Adult Rehabilitation, Xiangya Boai Rehabilitation Hospital, Changsha, Hunan, China
| | - Fang Qi
- Hunan University of Traditional Chinese Medicine, Changsha, Hunan, China
| | - Qingbo Li
- Hunan Children's Hospital, Rehabilitation Center, Changsha, Hunan, China
| | - Xuegang Jin
- Qinhuangdao Hospital of Traditional Chinese Medicine, Qinhuangdao, Hebei, China
| | - Huiling Hu
- Department of Rehabilitation Medicine, The Second Xiangya Hospital of Central South University, Renmin Road No. 139, Furong District, Changsha, 410000, Hunan, China.
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Madelaine L, Baste JM, Trousse D, Vidal R, Durand M, Pagès PB. Impact of robotic access on outcomes after lung cancer surgery in France: Analysis from the Epithor database. JTCVS OPEN 2023; 14:523-537. [PMID: 37425455 PMCID: PMC10328832 DOI: 10.1016/j.xjon.2023.02.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 01/30/2023] [Accepted: 02/06/2023] [Indexed: 07/11/2023]
Abstract
Introduction We aimed to compare postoperative outcomes after pulmonary resection for lung cancer after open thoracotomy (OT), video-assisted (VATS), and robotic-assisted (RA) thoracic surgery using a propensity score analysis. Methods From 2010 to 2020, 38,423 patients underwent resection for lung cancer. In total, 58.05% (n = 22,306) were operated by thoracotomy, 35.35% (n = 13,581) by VATS, and 6.6% (n = 2536) by RA. A propensity score was used to create balanced groups with weighting. End points were in-hospital mortality, postoperative complications, and length of hospital stay, reported by odds ratios (ORs) and 95% confidence intervals (CIs). Results VATS decreased in-hospital mortality compared with OT (OR, 0.64; 95% CI, 0.58-0.79; P < .0001) but not compared with RA (OR, 1.09; 95% CI, 0.77-1.52; P = .61). VATS reduced major postoperative complications compared with OT (OR, 0.83; 95% CI, 0.76-0.92; P < .0001) but not RA (OR, 1.01; 95% CI, 0.84-1.21; P = .17). VATS reduced prolonged air leaks rate compared with OT (OR, 0.9; 95% CI, 0.84-0.98; P = .015) but not RA (OR, 1.02; 95% CI, 0.88-1.18; P = .77). As compared with OT, VATS and RA decreased the incidence of atelectasis (respectively: OR, 0.57; 95% CI, 0.50-0.65; P < .0001 and OR, 0.75; 95% CI, 0.60-0.95; P = .016); the incidence of pneumonia (OR, 0.75; 95% CI, 0.67-0.83; P < .0001 and OR, 0.62; 95% CI, 0.50-0.78; P < .0001); and the number of postoperative arrhythmias (OR, 0.69; 95% CI, 0.61-0.78; P < .0001 and OR, 0.75; 95% CI, 0.59-0.96; P = .024). Both VATS and RA resulted in shorter hospital stays (-1.91 days [-2.24; -1.58]; P < .0001 and -2.73 days [-3.1; -2.36]; P < .0001, respectively). Conclusions RA appeared to decrease postoperative pulmonary complications as well as VATS compared with OT. VATS decreased postoperative mortality as compared with RA and OT.
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Affiliation(s)
- Leslie Madelaine
- Department of Thoracic Surgery, CHU Dijon, Bocage Central, Dijon, France
| | - Jean-Marc Baste
- Department of Thoracic Surgery, CHU Rouen, Hôpital Charles-Nicolle, Rouen, France
| | - Delphine Trousse
- Department of Thoracic Surgery and Esophageal, Hôpital Nord, CHU de Marseille, Marseille, France
| | - Renaud Vidal
- Department of Thoracic Surgery, Hôpital Européen, Marseille, France
| | - Marion Durand
- Department of Thoracic Surgery, Ramsay Santé, Hôpital Privé d’Antony, Antony, France
| | - Pierre-Benoit Pagès
- Department of Thoracic Surgery, CHU Dijon, Bocage Central, Dijon, France
- INSERM UMR 1231, CHU Dijon, University of Burgundy, Dijon, France
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Liu J, Yang X, Liu X, Xu Y, Huang H. Predictors of Readmission After Pulmonary Resection in Patients With Lung Cancer: A Systematic Review and Meta-analysis. Technol Cancer Res Treat 2022; 21:15330338221144512. [PMID: 36583561 PMCID: PMC9806362 DOI: 10.1177/15330338221144512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Objective: Postoperative readmissions are considered an indicator of healthcare quality. The purpose of this study was to assess the factors associated with readmission following pulmonary resection for lung cancer. Methods: A comprehensive search was performed in PubMed, Web of science, the Cochrane Library, and databases of CNKI and Wanfang. We collected the factors associated with readmission following pulmonary resection from the included studies, and data analysis was conducted with STATA SE12.0 software. Results: A total of 11 studies (386 012 participants) were included. The meta-analysis results showed that age (standardized mean difference [SMD] = 0.093), male sex (odds ratio [OR] = 1.260), Charlson score (SMD = 1.408), forced expiratory volume in 1 second predicted (SMD = -0.203), congestive heart failure (OR = 1.708), peripheral vascular disease (OR = 1.436), and histology (OR = 0.804) were associated with readmission (P < .05), while hypertension was not. Patients with postoperative empyema, pneumonia, air leak, and arrhythmia (all P < .05) had higher odds of hospital readmission. Conclusion: The predictive factors for readmission can help in establishing individualized discharge and follow-up plans and programs for reducing hospital readmissions after pulmonary resection in patients with lung cancer.
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Affiliation(s)
- Jie Liu
- Jiangxi Province Center for Disease Control and Prevention, Nanchang, China,Scientific Research and Innovation Team, Jiangxi Province Center for Disease Control and Prevention, Nanchang, China
| | - Xuli Yang
- Scientific Research and Innovation Team, Jiangxi Province Center for Disease Control and Prevention, Nanchang, China,Xuli Yang, Department of Quality Control, The First Affiliated Hospital of Nanchang University, Nanchang, China.
| | - Xing Liu
- The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Yan Xu
- The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Helang Huang
- School of Public Health, Nanchang University, Nanchang, China
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Alwatari Y, Khoraki J, Wolfe LG, Ramamoorthy B, Wall N, Liu C, Julliard W, Puig CA, Shah RD. Trends of utilization and perioperative outcomes of robotic and video-assisted thoracoscopic surgery in patients with lung cancer undergoing minimally invasive resection in the United States. JTCVS OPEN 2022; 12:385-398. [PMID: 36590738 PMCID: PMC9801282 DOI: 10.1016/j.xjon.2022.07.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 06/04/2022] [Accepted: 07/05/2022] [Indexed: 04/27/2023]
Abstract
OBJECTIVE The objective of this study was to evaluate utilization and perioperative outcomes of video-assisted thoracoscopic surgery (VATS) or robotic-assisted thoracoscopic surgery (RATS) for lung cancer in the United States using a nationally representative database. METHODS Hospital admissions for lobectomy or sublobar resection (segmentectomy or wedge resection) using VATS or RATS in patients with nonmetastatic lung cancer from October 2015 through December 2018 in the National Inpatient Sample were studied. Patient and hospital characteristics, perioperative complications and mortality, length of stay (LOS), and total hospital cost were compared. Logistic regression was used to assess whether the surgical approach was independently associated with adverse outcomes. RESULTS There were 83,105 patients who had VATS (n = 65,375) or RATS (n = 17,710) for lobectomy (72.7% VATS) or sublobar resection (84.2% VATS). Utilization of RATS for lobectomy and sublobar resection increased from 19.2% to 34% and 7.3% to 22%, respectively. Mortality, LOS, and conversion rates were comparable. The cost was higher for RATS (P <.01). Multivariate analyses showed comparable RATS and VATS complications with no independent association between the minimally invasive surgery approach used and adverse surgical outcomes, except for a decreased risk of pneumonia with RATS, relative to VATS sublobar resection (P <.01). Thoracic complication rates and LOS decreased after RATS lobectomy in 2018, compared with previous years (P <.005). CONCLUSIONS The utilization of robotic-assisted lung resection for cancer has increased in the United States between 2015 and 2018 for sublobar resection and lobectomy. In adjusted regression analysis, compared with VATS, patients who underwent RATS had similar complication rates and LOS. The robotic approach was associated with increased total hospital cost. LOS and thoracic complication rates trended down after RATS lobectomy.
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Key Words
- HCUP, Healthcare Cost and Utilization Project
- ICD-10, International Classification of Diseases, 10th Revision
- ICD-10-CM, International Classification of Diseases, 10th Revision, Clinical Modification
- ICD-10-PCS, International Classification of Diseases, 10th Revision Procedure Coding System
- LOS, length of stay
- MIS, minimally invasive surgery
- NIS, National Inpatient Sample
- Q4, fourth quarter
- RATS, robotic-assisted thoracoscopic surgery
- VATS, video-assisted thoracoscopic surgery
- lung cancer
- robotic
- video-assisted thoracoscopic surgery
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Affiliation(s)
- Yahya Alwatari
- Address for reprints: Yahya Alwatari, MD, 1200 E Marshall St, Richmond, VA 23298.
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Zheng Y, Mao M, Li F, Wang L, Zhang X, Zhang X, Wang H, Zhou H, Ji M, Wang Y, Liu L, Zhu Q, Reinhardt JD, Lu X. Effects of enhanced recovery after surgery plus pulmonary rehabilitation on complications after video-assisted lung cancer surgery: a multicentre randomised controlled trial. Thorax 2022; 78:574-586. [PMID: 35835552 DOI: 10.1136/thoraxjnl-2021-218183] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Accepted: 05/25/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND Lung cancer surgery is associated with a high incidence of postoperative pulmonary complications (PPCs). We evaluated whether enhanced recovery after surgery plus pulmonary rehabilitation was superior over enhanced recovery after surgery alone in reducing the incidence of postoperative PPCs and length of hospital stay. METHODS In this pragmatic multicentre, randomised controlled, parallel-group clinical trial, eligible patients scheduled for video-assisted lung cancer surgery were randomly assigned (1:1) to either a newly developed programme that integrated preoperative and postoperative pulmonary rehabilitation components into a generic thoracic enhanced recovery after surgery pathway, or routine thoracic enhanced recovery after surgery. Primary outcome was the overall occurrence of PPCs within 2 weeks after surgery. Secondary outcomes were the occurrence of specific complications, time to removal of chest drain, and length of hospital stay (LOS). RESULTS Of 428 patients scheduled for lung cancer surgery, 374 were randomised with 187 allocated to the experimental programme and 187 to control. Incidence of PPCs at 14 Days was 18.7% (35/187) in the experimental group and 33.2% (62/187) in the control group (intention-to-treat, unadjusted HR 0.524, 95% CI 0.347 to 0.792, p=0.002). Particularly, significant risk reduction was observed regarding pleural effusion, pneumonia and atelectasis. Time to removal of chest drain and LOS were not significantly reduced in the experimental group. CONCLUSIONS Adding pulmonary rehabilitation to enhanced recovery after surgery appears to be effective in reducing the incidence of PPCs, but not LOS. Standard integration of pulmonary rehabilitation into thoracic enhanced recovery after surgery is a promising approach to PPC prophylaxis. TRIAL REGISTRATION NUMBER ChiCTR1900024646.
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Affiliation(s)
- Yu Zheng
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Mao Mao
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Fang Li
- Department of Thoracic Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Lu Wang
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.,Department of Rehabilitation Medicine, Qingdao Municipal Hospital Group, Qingdao, Shandong, China
| | - Xintong Zhang
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Xiu Zhang
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Haiming Wang
- Department of Rehabilitation Medicine, Zhengzhou University First Affiliated Hospital, Zhengzhou, Henan, China
| | - Huiqing Zhou
- Department of Rehabilitation Therapy, Taizhou Enze Medical Center, Tai Zhou, Zhejiang, China
| | - Meifang Ji
- Department of Rehabilitation Therapy, the Second Affiliated Hospital of Hainan Medical University, Hainan, China
| | - Yulong Wang
- Department of Rehabilitation Medicine, Shenzhen Dapeng New District Nan'ao People's Hospital, Shenzhen, China
| | - Liang Liu
- Department of Rehabilitation Medicine, Nanjing Drum Tower Hospital, Nanjing, Jiangsu, China
| | - Quan Zhu
- Department of Thoracic Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Jan D Reinhardt
- Institute for Disaster Management and Reconstruction, Sichuan University, Chengdu, Sichuan, China .,Swiss Paraplegic Research, Nottwil, Switzerland.,Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland.,Rehabilitation Research Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Xiao Lu
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
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Zou H, Qin Y, Gong F, Liu J, Zhang J, Zhang L. ABCDEF pulmonary rehabilitation program can improve the mid-term lung function of lung cancer patients after thoracoscopic surgery: A randomized controlled study. Geriatr Nurs 2022; 44:76-83. [DOI: 10.1016/j.gerinurse.2021.12.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 12/29/2021] [Accepted: 12/30/2021] [Indexed: 11/28/2022]
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Veronesi G, Novellis P, Perroni G. Overview of the outcomes of robotic segmentectomy and lobectomy. J Thorac Dis 2021; 13:6155-6162. [PMID: 34795966 PMCID: PMC8575815 DOI: 10.21037/jtd-20-1752] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 07/31/2020] [Indexed: 11/30/2022]
Abstract
Segmentectomy has gained popularity in the latest years as a valid alternative to lobectomy. Initially reserved to patient unfit for lobar lung resection, this procedure is now offered also in selected patient with <2 cm peripheral lung cancer confined to an anatomic segment with no nodal involvement on preoperative evaluation. The introduction of screening with low-dose CT chest scan allowed the identification of lung cancer at early stages, making possible to schedule a more conservative lung surgery. A major improvement came also from minimally invasive surgery (MIS), reducing complication rate with comparable survival rates when compared to open surgery. However, due to long learning curve and uncomfortable instruments handling of video-assisted thoracoscopy, many surgeons still prefer to perform segmentectomies through a thoracotomy and thus increasing perioperative morbidity and leading to post-thoracotomy syndrome due to rib-spreading. Robotic assisted thoracic surgery (RATS) can avoid this throwback, combining the handling of open surgery with lesser invasiveness of thoracoscopy. Although literature has given strong evidences in favour of robotic lobectomies, data are still limited regarding segmentectomies performed with this technique. Moreover, no results are still available from the two ongoing randomized controlled trials comparing segmentectomy to lobectomy and so the latter represent the oncologically proper procedure for lung cancer along with lymph-node dissection. In this review we analyse the literature currently available on outcomes of lobar and sublobar anatomical resection performed by RATS, with a brief mention of the existing surgical techniques of port positioning and the costs of this procedure.
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Affiliation(s)
- Giulia Veronesi
- Faculty of Medicine and Surgery, Vita-Salute San Raffaele University, Milan, Italy.,Division of Thoracic Surgery, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Pierluigi Novellis
- Division of Thoracic Surgery, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Gianluca Perroni
- Department of Thoracic Surgery, Humanitas Clinical and Research Center-IRCCS, Rozzano (Mi), Italy
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10
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Factors associated with unplanned readmissions and costs following resection of brain metastases in the United States. Sci Rep 2021; 11:22152. [PMID: 34773051 PMCID: PMC8589950 DOI: 10.1038/s41598-021-01641-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 10/18/2021] [Indexed: 11/13/2022] Open
Abstract
The purpose of this study was to critically analyze the risk of unplanned readmission following resection of brain metastasis and to identify key risk factors to allow for early intervention strategies in high-risk patients. We analyzed data from the Nationwide Readmissions Database (NRD) from 2010–2014, and included patients who underwent craniotomy for brain metastasis, identified using ICD-9-CM diagnosis (198.3) and procedure (01.59) codes. The primary outcome of the study was unplanned 30-day all-cause readmission rate. Secondary outcomes included reasons and costs of readmissions. Hierarchical logistic regression model was used to identify the factors associated with 30-day readmission following craniotomy for brain metastasis. During the study period, 44,846 index hospitalizations occurred for patients who underwent resection of brain metastasis. In this cohort, 17.8% (n = 7,965) had unplanned readmissions within the first 30 days after discharge from the index hospitalization. The readmission rate did not change significantly during the five-year study period (p-trend = 0.286). The median per-patient cost for 30-day unplanned readmission was $11,109 and this amounted to a total of $26.4 million per year, which extrapolates to a national expenditure of $269.6 million. Increasing age, male sex, insurance status, Elixhauser comorbidity index, length of stay, teaching status of the hospital, neurological complications and infectious complications were associated with 30-day readmission following discharge after an index admission for craniotomy for brain metastasis. Unplanned readmission rates after resection of brain metastasis remain high and involve substantial healthcare expenditures. Developing tools and interventions to prevent avoidable readmissions could focus on the high-risk patients as a future strategy to decrease substantial healthcare expense.
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Chen W, Yu Z, Zhang Y, Liu H. Comparison of cost effectiveness between video-assisted thoracoscopic surgery (vats) and open lobectomy: a retrospective study. COST EFFECTIVENESS AND RESOURCE ALLOCATION 2021; 19:55. [PMID: 34454507 PMCID: PMC8400899 DOI: 10.1186/s12962-021-00307-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Accepted: 08/11/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Lung cancer is highly prevalent in Chinese population. The association of operative approach with economic burden in these patients remains unknown. OBJECTIVES This institution-level cohort study aimed to compare the cost-related clinical outcomes and health care costs among patients undergoing video-assisted thoracoscopic surgery (VATS) and open lobectomy, and to investigate the factors associated with the costs. METHODS This retrospective cohort study included patients who underwent VATS or open lobectomy in a provincial referral cancer center in China in 2018. Propensity score matching (PSM) method was applied to balance the baseline characteristics in VATS lobectomy and open lobectomy group. Clinical effectiveness measures included post-operative blood transfusion, lung infection, and length of stay (LOS). Hospitalization costs were extracted from hospital information system to assess economic burden. Multivariable generalized linear model (GLM) with gamma probability distribution and log-link was used to analyze the factors associated with total costs. RESULTS After PSM, 376 patients were selected in the analytic sample. Compared to open lobectomy group, the VATS lobectomy group had a lower blood transfusion rate (2.13% vs. 3.19%, P = 0.75), lower lung infection rate (21.28% vs. 39.89%, P < 0.001) and shorter post-operative LOS (9.4 ± 3.22 days vs. 10.86 ± 4.69 days, P < 0.001). Total hospitalization costs of VATS lobectomy group and open lobectomy were similar: Renminbi (RMB) 84398.03 ± 13616.13, RMB 81,964.92 ± 16748.11, respectively (P = 0.12). Total non-surgery costs were significantly lower in the VATS lobectomy group than in the open lobectomy group: RMB 41948.40 ± 7747.54 vs. RMB 45752.36 ± 10346.42 (P < 0.001). VATS approach, lung infection, longer post-operative length of stay, health insurance coverage, and lung cancer diagnosis were associated with higher total hospitalization costs (P < 0.05). CONCLUSIONS VATS lobectomy has a lower lung infection rate, and shorter post-operative LOS than open lobectomy. Future studies are needed to investigate other aspects of clinical effectiveness and the economic burden from a societal perspective.
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Affiliation(s)
- Wei Chen
- Department of Thoracic Surgery, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, No. 44 Xiaoheyan Road, Shenyang, 110042, Liaoning, P.R. China
| | - Zhanwu Yu
- Department of Thoracic Surgery, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, No. 44 Xiaoheyan Road, Shenyang, 110042, Liaoning, P.R. China
| | - Yichen Zhang
- Department of Health Policy and Management, Tulane University, School of Public Health and Tropical Medicine, New Orleans, LA, 70112, USA
| | - Hongxu Liu
- Department of Thoracic Surgery, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, No. 44 Xiaoheyan Road, Shenyang, 110042, Liaoning, P.R. China.
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Uptake and survival effects of minimally invasive surgery for lung cancer: A population-based study. Eur J Surg Oncol 2021; 47:1791-1796. [PMID: 33468371 DOI: 10.1016/j.ejso.2021.01.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 12/03/2020] [Accepted: 01/06/2021] [Indexed: 11/20/2022] Open
Abstract
INTRODUCTION Despite growing evidence supporting the safety of minimally invasive surgery (MIS) in the treatment of lung cancer, its uptake is still variable and its outcomes debated. This study examines the factors associated with MIS uptake and its effects on survival in patients with non-small cell lung cancer (NSCLC). METHODS All patients in the Canadian province of Ontario with early stage NSCLC (stage I/II) from 2007 to 2017 were included. A logistic regression identified the predictors of MIS uptake, and a flexible parametric model was used to estimate survival rates based on MIS versus open resection. RESULTS In total, 8,988 patients underwent surgical resection; 53.6% had MIS. Year of diagnosis was associated with MIS uptake (OR = 1.33, p < 0.001); patients in later years were more likely to receive MIS. Rurality was a significant predictor of MIS, though distance from nearest regional cancer center did not predict MIS utilization. Patients with stage II disease were less likely to receive MIS compared to those with stage I disease (OR = 0.44, p < 0.001). MIS had a significantly higher 5-year survival compared to open resection for stage I and II disease. Patients >70 years had the greatest 5-year survival benefit from MIS. CONCLUSIONS We observed a substantial long-term survival benefit in patients undergoing MIS for early stage NSCLC. This difference was most pronounced in the oldest age group. These findings support the use of MIS in the treatment of lung cancer and challenge the notion that MIS compromises oncologic outcomes.
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Impact of Neoadjuvant Chemoradiation on Adverse Events After Bronchial Sleeve Resection. Ann Thorac Surg 2020; 112:890-896. [PMID: 33171174 DOI: 10.1016/j.athoracsur.2020.10.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 10/07/2020] [Accepted: 10/12/2020] [Indexed: 11/21/2022]
Abstract
BACKGROUND We analyzed the association between neoadjuvant chemoradiation in patients undergoing bronchial sleeve resection with the incidence of postoperative pulmonary and airway complications. METHODS After instructional review board approval we performed a retrospective review of a prospectively maintained database of 136 patients who underwent sleeve resection in our institution between January 1998 and December 2016. Administration of neoadjuvant chemoradiation treatment was the studied exposure. Outcomes of interest were rates of postoperative pulmonary and airway complications. Nonparametric testing of demographic, surgical, and pathologic characteristics and morbidity was performed. Logistic regression models evaluated postoperative pulmonary complications and airway complications. Analysis was performed using Stata/IC 15. RESULTS We analyzed 136 patients (18 underwent neoadjuvant chemoradiation), 77 (57%) of whom had non-small cell lung cancer. Postoperative pulmonary complications were observed in 44 of 136 patients (32%). Incidences of pulmonary complications were higher in the neoadjuvant chemoradiation group compared with the non-neoadjuvant radiation group (15/18 patients [83%] vs 29/118 patients [25%], respectively; P < .001). Likewise, rates of pneumonia, atelectasis, respiratory insufficiency, bronchial stenosis, prolonged air leak, bronchopleural fistula, and completion pneumonectomy (2/18 [11%]) were higher in the neoadjuvant chemoradiation group, reaching statistical significance in all cases except bronchial stenosis and prolonged air leak. Only neoadjuvant chemoradiation therapy remained significant for postoperative pulmonary and airway complications on logistic regression (both P < .05) CONCLUSIONS: Patients who undergo neoadjuvant chemoradiation before sleeve resection are at an increased risk of pulmonary and airway complications.
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Aiolfi A, Nosotti M, Micheletto G, Khor D, Bonitta G, Perali C, Marin J, Biraghi T, Bona D. Pulmonary lobectomy for cancer: Systematic review and network meta-analysis comparing open, video-assisted thoracic surgery, and robotic approach. Surgery 2020; 169:436-446. [PMID: 33097244 DOI: 10.1016/j.surg.2020.09.010] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Revised: 08/25/2020] [Accepted: 09/12/2020] [Indexed: 01/22/2023]
Abstract
BACKGROUND Although minimally invasive lobectomy has gained worldwide interest, there has been debate on perioperative and oncological outcomes. The purpose of this study was to compare outcomes among open lobectomy, video-assisted thoracic surgery lobectomy, and robotic lobectomy. METHODS PubMed, EMBASE, and Web of Science databases were consulted. A fully Bayesian network meta-analysis was performed. RESULTS Thirty-four studies (183,426 patients) were included; 88,865 (48.4%) underwent open lobectomy, 79,171 (43.2%) video-assisted thoracic surgery lobectomy, and 15,390 (8.4%) robotic lobectomy. Compared with open lobectomy, video-assisted thoracic surgery, lobectomy and robotic lobectomy had significantly reduced 30-day mortality (risk ratio = 0.53; 95% credible intervals, 0.40-0.66 and risk ratio = 0.51; 95% credible intervals, 0.36-0.71), pulmonary complications (risk ratio = 0.70; 95% credible intervals, 0.51-0.92 and risk ratio = 0.69; 95% credible intervals, 0.51-0.88), and overall complications (risk ratio = 0.77; 95% credible intervals, 0.68-0.85 and risk ratio = 0.79; 95% credible intervals, 0.67-0.91). Compared with video-assisted thoracic surgery lobectomy, open lobectomy, and robotic lobectomy had a significantly higher total number of harvested lymph nodes (mean difference = 1.46; 95% credible intervals, 0.30, 2.64 and mean difference = 2.18; 95% credible intervals, 0.52-3.92) and lymph nodes stations (mean difference = 0.37; 95% credible intervals, 0.08-0.65 and mean difference = 0.93; 95% credible intervals, 0.47-1.40). Positive resection margin and 5-year overall survival were similar across treatments. Intraoperative blood loss, postoperative transfusion, hospital length of stay, and 30-day readmission were significantly reduced for minimally invasive approaches. CONCLUSION Compared with open lobectomy, video-assisted thoracic surgery lobectomy, and robotic lobectomy seem safer with reduced 30-day mortality, pulmonary, and overall complications with equivalent oncologic outcomes and 5-year overall survival. Minimally invasive techniques may improve outcomes and surgeons should be encouraged, when feasible, to adopt video-assisted thoracic surgery lobectomy, or robotic lobectomy in the treatment of lung cancer.
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Affiliation(s)
- Alberto Aiolfi
- Department of Biomedical Science for Health, Division of General Surgery, University of Milan, Istitituto Clinico Sant'Ambrogio, Milan, Italy.
| | - Mario Nosotti
- Department of Pathophysiology and Transplantation, Thoracic Surgery and Lung Transplant Unit Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milan, Italy
| | - Giancarlo Micheletto
- Department of Pathophysiology and Transplantation, INCO and Department of General Surgery, University of Milan, Istituto Clinico Sant'Ambrogio, Milan, Italy
| | - Desmond Khor
- University of Maryland Medical Center, Baltimore, MD
| | - Gianluca Bonitta
- Department of Biomedical Science for Health, Division of General Surgery, University of Milan, Istitituto Clinico Sant'Ambrogio, Milan, Italy
| | - Carolina Perali
- Department of Biomedical Science for Health, Division of General Surgery, University of Milan, Istitituto Clinico Sant'Ambrogio, Milan, Italy
| | - Jacopo Marin
- Department of Biomedical Science for Health, Division of General Surgery, University of Milan, Istitituto Clinico Sant'Ambrogio, Milan, Italy
| | - Tullio Biraghi
- Department of Biomedical Science for Health, Division of General Surgery, University of Milan, Istitituto Clinico Sant'Ambrogio, Milan, Italy
| | - Davide Bona
- Department of Biomedical Science for Health, Division of General Surgery, University of Milan, Istitituto Clinico Sant'Ambrogio, Milan, Italy
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Shaftel KA, Cole TS, Little AS. National trends in hospital readmission following transsphenoidal surgery for pituitary lesions. Pituitary 2020; 23:79-91. [PMID: 31728907 DOI: 10.1007/s11102-019-01007-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
PURPOSE Several institutions recently published their experiences with unplanned readmissions rates after transsphenoidal surgery for pituitary lesions. Readmission rates on a national level, however, have not been explored in depth. We investigated nationwide trends in this procedure and associated independent predictors, costs, and causes of 30-day readmission. METHODS The Nationwide Readmissions Database was queried to identify patients 18 and older who underwent transsphenoidal surgery for pituitary lesion resection (2010-2015). National trends and statistical variances were calculated based on weighted, clustered, and stratified sample means. RESULTS Of the weighted total of 44,759 patients treated over the 6-year period, 4658 (10.4%) were readmitted within 30 days. Readmission rates did not change across the survey period (P = 0.71). Patients readmitted had a higher prevalence of comorbidities than those not readmitted (82.5% vs. 78.4%, respectively, P < 0.001), experienced more postoperative complications (47.2% vs. 31.8%, P < 0.001), and had a longer length of stay (6.59 vs. 4.23 days, P < 0.001) during index admission. The most common causes for readmission were SIADH (17.5%) and other hyponatremia (16.4%). Average total readmission cost was $12,080 with no significant trend across the study period (P = 0.25). Predictors for readmission identified included diabetes mellitus, psychological disorders, renal failure, and experiencing diabetes insipidus during the index admission. CONCLUSION Unplanned readmission is an important quality metric. While transsphenoidal pituitary surgery is a relatively safe procedure, 30-day readmission rates and costs have not declined. Future studies on institutional protocols targeting these identified predictors to prevent readmission are necessary to decrease readmission rates on a national scale.
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Affiliation(s)
- Kelly A Shaftel
- Department of Neurosurgery, Barrow Neurological Institute, Phoenix, AZ, USA
| | - Tyler S Cole
- Department of Neurosurgery, Barrow Neurological Institute, Phoenix, AZ, USA
| | - Andrew S Little
- Department of Neurosurgery, Barrow Neurological Institute, Phoenix, AZ, USA.
- c/o Neuroscience Publications, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, 350 W. Thomas Rd., Phoenix, AZ, 85013, USA.
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Zheng Y, Mao M, Ji M, Zheng Q, Liu L, Zhao Z, Wang H, Wei X, Wang Y, Chen J, Zhou H, Liang Q, Chen Y, Zhang X, Wang L, Cheng Y, Zhang X, Teng M, Lu X. Does a pulmonary rehabilitation based ERAS program (PREP) affect pulmonary complication incidence, pulmonary function and quality of life after lung cancer surgery? Study protocol for a multicenter randomized controlled trial. BMC Pulm Med 2020; 20:44. [PMID: 32070326 PMCID: PMC7029521 DOI: 10.1186/s12890-020-1073-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Accepted: 01/31/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Lung cancer surgery is associated with a high incidence of postoperative pulmonary complications (PPCs). Preliminary evidence suggests that ERAS processes can reduce overall incidence of PPCs as short- and long-term recovery improved by supporting units to adopt evidence-based care. However, the evidence is inconclusive due to insufficient high-level studies in this research field. No well-designed, adequately powered, randomized controlled trials (RCTs) have investigated the effects of pulmonary rehabilitation based ERAS program (PREP) on post-operative pulmonary complications, pulmonary function, and health related quality of life following lung cancer surgery. METHODS The PREP trial is a pragmatic, investigator-initiated, multi-center, randomized controlled, parallel group, clinical trial. Five hundred patients scheduled for minimally invasive pulmonary resection at six hospitals in China will be randomized with concealed allocation to receive either i) a pre-operative assessment and an information booklet or ii) a pre-operative assessment, an information booklet, plus an additional education, a 30-min pulmonary rehabilitation training session and the post-operative pulmonary rehabilitation program. The primary outcome is incidence of PPCs defined with the Melbourne Group Scale diagnostic scoring tool. Secondary outcomes include incidence of cardiopulmonary and other complications, pulmonary function, cardiopulmonary endurance, muscle strength, activity level, health-related quality of life (HRQoL), pre- and post-operative hospital length of stay (LOS), and total hospital LOS. DISCUSSION The PREP trial is designed to verify the hypothesis that pulmonary rehabilitation based ERAS program reduces incidence of PPCs and improves pulmonary function and HRQoL in patients following lung cancer surgery. This trial will furthermore contribute significantly to the limited knowledge about the pulmonary rehabilitation based ERAS program following lung cancer surgery, and may thereby form the basis of future recommendations in the surgical community. TRIAL REGISTRATION Chinese Clinical Trial Registry: ChiCTR1900024646, 21 July 2019.
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Affiliation(s)
- Yu Zheng
- Department of Rehabilitation Medicine, the First Affiliated Hospital of Nanjing Medical University, No.300 Guangzhou Road, Nanjing, 210029, China
| | - Mao Mao
- Department of Rehabilitation Medicine, the First Affiliated Hospital of Nanjing Medical University, No.300 Guangzhou Road, Nanjing, 210029, China
| | - Meifang Ji
- Department of Rehabilitation Therapy, the Second Affiliated Hospital of Hainan Medical University, No. 368 Yehai Road, Haikou, 570100, China
| | - Qiugang Zheng
- Department of Rehabilitation Therapy, the Second Affiliated Hospital of Hainan Medical University, No. 368 Yehai Road, Haikou, 570100, China
| | - Liang Liu
- Department of Rehabilitation Medicine, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, No. 321 Zhongshan Road, Nanjing, 210008, China
| | - Zhigang Zhao
- Department of Rehabilitation Medicine, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, No. 321 Zhongshan Road, Nanjing, 210008, China
| | - Haiming Wang
- Department of Rehabilitation Medicine, the First Affiliated Hospital of Zhengzhou University, No. 1 East of Jianshe Road, Zhengzhou, 450052, China
| | - Xiangyang Wei
- Department of Rehabilitation Medicine, the First Affiliated Hospital of Zhengzhou University, No. 1 East of Jianshe Road, Zhengzhou, 450052, China
| | - Yulong Wang
- Department of Rehabilitation Medicine, Shenzhen Dapeng New District Nan'ao People's Hospital, No. 6 Renmin Road, Dapeng New District, Shenzhen, 518000, China
| | - Jiamin Chen
- Department of Rehabilitation Medicine, Shenzhen Dapeng New District Nan'ao People's Hospital, No. 6 Renmin Road, Dapeng New District, Shenzhen, 518000, China
| | - Huiqing Zhou
- Department of Rehabilitation Therapy, Taizhou Enze Medical Center, Enze Hospital, No. 1 East of Tongyang Road, Taizhou, 318050, China
| | - Qiaoqiao Liang
- Department of Rehabilitation Therapy, Taizhou Enze Medical Center, Enze Hospital, No. 1 East of Tongyang Road, Taizhou, 318050, China
| | - Ying Chen
- Department of Rehabilitation Medicine, the First Affiliated Hospital of Nanjing Medical University, No.300 Guangzhou Road, Nanjing, 210029, China
| | - Xintong Zhang
- Department of Rehabilitation Medicine, the First Affiliated Hospital of Nanjing Medical University, No.300 Guangzhou Road, Nanjing, 210029, China
| | - Lu Wang
- Department of Rehabilitation Medicine, the First Affiliated Hospital of Nanjing Medical University, No.300 Guangzhou Road, Nanjing, 210029, China
| | - Yihui Cheng
- Department of Rehabilitation Medicine, the First Affiliated Hospital of Nanjing Medical University, No.300 Guangzhou Road, Nanjing, 210029, China
| | - Xiu Zhang
- Department of Rehabilitation Medicine, the First Affiliated Hospital of Nanjing Medical University, No.300 Guangzhou Road, Nanjing, 210029, China
| | - Meiling Teng
- Department of Rehabilitation Medicine, the First Affiliated Hospital of Nanjing Medical University, No.300 Guangzhou Road, Nanjing, 210029, China
| | - Xiao Lu
- Department of Rehabilitation Medicine, the First Affiliated Hospital of Nanjing Medical University, No.300 Guangzhou Road, Nanjing, 210029, China.
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Nakao M, Ichinose J, Matsuura Y, Okumura S, Mun M. Determining the most important factors in hospital readmission following surgery for lung cancer. ANNALS OF TRANSLATIONAL MEDICINE 2020; 7:S269. [PMID: 32015988 DOI: 10.21037/atm.2019.12.29] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Masayuki Nakao
- Department of Thoracic Surgical Oncology, Cancer Institute Hospital, The Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Junji Ichinose
- Department of Thoracic Surgical Oncology, Cancer Institute Hospital, The Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Yosuke Matsuura
- Department of Thoracic Surgical Oncology, Cancer Institute Hospital, The Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Sakae Okumura
- Department of Thoracic Surgical Oncology, Cancer Institute Hospital, The Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Mingyon Mun
- Department of Thoracic Surgical Oncology, Cancer Institute Hospital, The Japanese Foundation for Cancer Research, Tokyo, Japan
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Elliott IA, Yanagawa J. Can the robot overcome technical challenges of thoracoscopic bronchial anastomosis? J Thorac Dis 2019; 11:S1123-S1125. [PMID: 31245060 DOI: 10.21037/jtd.2019.04.100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Irmina A Elliott
- Division of Thoracic Surgery, Department of Surgery, UCLA, Los Angeles, CA, USA
| | - Jane Yanagawa
- Division of Thoracic Surgery, Department of Surgery, UCLA, Los Angeles, CA, USA
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