Analysis of the multidisciplinary team in the surgical treatment of lung cancer by video-assisted thoracoscopic surgery_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

WANG Pengfei ^1,2 , DAI Weina ¹ , LIU Lixin ² , YUE Peng ² ,  HAN Biao ²

1. First Clinical Medical College, Lanzhou University, Lanzhou, 730030, P.R.China;
2. Thoracic Surgery Department, Lanzhou University First Hospital, Lanzhou, 730030, P.R.China;

Corresponding?author：

HAN Biao, Email: hanbiao66@163.com

Keywords：

Multidisciplinary team; lung cancer; thoracoscope; complications; clinical efficacy

DOI：

10.7507/1007-4848.201903042

Video：

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Objective To investigate the effect of multidisciplinary team (MDT) on perioperative complications and clinical efficacy of patients who were receiver radical operation to treat lung cancer by video-assisted thoracoscopic surgery (VATS). Methods Eighty patients in the Thoracic Surgery Department of First Hospital of Lanzhou University from December 2017 to February 2019 who were diagnosed lung cancer were divided into two groups. Forty patients in the MDT group were treated with MDT discussion. The control group consisted of 40 patients who were treated without MDT discussion. The incidence of postoperative complications and clinical efficacy were compared between the two groups . Results There was no statistical difference in incision infection, atelectasis, pleural effusion and pulmonary leakage between the two groups. However, the incidence of postoperative pulmonary infection (5% vs. 20%, P=0.043) and the overall postoperative complications (17.5% vs. 42.5%, P=0.015) in the MDT group was lower than that in the control group with a statistical difference. In the MDT group, the operative time (140.3±8.0 min vs. 148.8±6.8 min, P<0.001), intraoperative bleeding ( 207.8±19.4 mL vs. 222.0±28.3 mL, P=0.010), lymph node dissection number (25.1±6.2 vs. 20.1±7.0, P=0.001), postoperative drainage (273.0±33.5 mL vs. 24.0±52.5 mL, P<0.001), drainage duration (81.9±6.1 h vs. 85.3±8.1 h, P=0.039), pain on the first day after surgery (4.6±0.7 vs. 5.4±0.7), P<0.001), pain on the second day (2.5±0.7 vs. 3.0±0.8, P=0.002), pain on the third day (1.1±0.8 vs. 1.5±0.6, P=0.014), postoperative activity time (40.7±6.7 h vs. 35.3±7.1 h, P<0.001), postoperative recovery time (6.8±0.9 d vs. 7.4±0.7 d, P=0.003), patient satisfaction (8.1±1.4 vs. 7.2±2.0, P=0.020) were significantly better than those of the control group with statistical differences. But there was no statistical difference in the conversion to thoracotomy between the two group. Conclusion MDT discussion can reduce the surgical risk and postoperative complications, improve the clinical efficacy and accelerate the postoperative rehabilitation of patients, which has a good clinical significance.

Citation： WANG Pengfei, DAI Weina, LIU Lixin, YUE Peng, HAN Biao. Analysis of the multidisciplinary team in the surgical treatment of lung cancer by video-assisted thoracoscopic surgery. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2019, 26(12): 1185-1189. doi: 10.7507/1007-4848.201903042 Copy

1.	Akhurst T. Staging of non-small-cell lung cancer. PET Clin, 2018, 13(1): 1-10.
2.	Jr MK, Houck W, Fuller CB. Video-assisted thoracic surgery lobectomy: experience with 1,100 cases. Ann Thorac Surg, 2006, 81(2): 421-425.
3.	中華醫學會, 中華醫學會腫瘤學分會, 中華醫學會雜志社. 中華醫學會肺癌臨床診療指南(2018 版). 中華腫瘤雜志, 2018, 40(12): 935.
4.	Liu H, Song Y. MDT is still important in the treatment of early stage lung cancer. J Thorac Dis, 2018, 10(Suppl 33): S3984-S3985.
5.	霍小東, 于振濤. 多學科團隊在食管癌診斷與治療中的作用. 中國腫瘤臨床, 2016, 43(12): 502-506.
6.	岳東升, 張華天. 非小細胞肺癌術后輔助治療中國胸外科專家共識(2018 版). 中國肺癌雜志, 2018, 21(10): 14-20.
7.	陸小英, 趙存鳳, 張婷婷, 等. “長海痛尺”在疼痛評估中的應用. 解放軍護理雜志, 2003, 20(4): 6-7.
8.	Barratt SL, Morales M, Spiers T, et al. Specialist palliative care, psychology, interstitial lung disease (ILD) multidisciplinary team meeting: a novel model to address palliative care needs. BMJ Open Respir Res, 2018, 5(1): e000360.
9.	張曉利. 泌尿腫瘤 MDT 中國創新模式“成長記”. 中國醫院院長, 2018, (23): 42-44.
10.	Mokhles S, Nuyttens JJME, De Mol M, et al. Treatment selection of early stage non-small cell lung cancer: the role of the patient in clinical decision making. BMC Cancer, 2018, 18(1): 79.
11.	袁瑛, 徐棟, 楊琦, 等. 直腸癌伴同時性多發性肺轉移患者的多學科臨床決策探討. 中國腫瘤臨床, 2017, 44(19): 973-978.
12.	Gandamihardja TAK, Soukup T, Mcinerney S, et al. Analysing breast cancer multidisciplinary patient management: a prospective observational evaluation of team clinical decision-making. World J Surg, 2018: 1-8.
13.	韋淑貞, 山順林. 非小細胞肺癌多學科治療的新進展. 現代腫瘤醫學, 2010, 18(4): 828-830.
14.	Bydder S, Nowak A, Marion K, et al. The impact of case discussion at a multidisciplinary team meeting on the treatment and survival of patients with inoperable non-small cell lung cancer. Inter Med J, 2010, 39(12): 838-841.
15.	Emily S, Nicole R, Stephen K, et al. Does presentation at multidisciplinary team meetings improve lung cancer survival? Findings from a consecutive cohort study. Lung Cancer, 2018, 124: 199-204.
16.	Connolly MJ, Broad JB, Bish T, et al. Reducing emergency presentations from long-term care: A before-and-after study of a multidisciplinary team intervention. Maturitas, 2018, 117: 45-50.
17.	朱云柯, 林琳, 劉倫旭, 等. 中國胸外科圍手術期疼痛管理專家共識(2018 版). 中國胸心血管外科臨床雜志, 2018, 25(11): 921-928.
18.	Burden M, Thornton M. Reducing the risks of surgical site infection: the importance of the multidisciplinary team. Br J Nursing, 2018, 27(17): 976-979.
19.	曹雄, 藺瑞江, 李仁鵬, 等. 多學科診療模式在非小細胞肺癌手術治療過程中的應用價值. 中國胸心血管外科臨床雜志, 2019, 26(8): 780-783.

1. Akhurst T. Staging of non-small-cell lung cancer. PET Clin, 2018, 13(1): 1-10.
2. Jr MK, Houck W, Fuller CB. Video-assisted thoracic surgery lobectomy: experience with 1,100 cases. Ann Thorac Surg, 2006, 81(2): 421-425.
3. 中華醫學會, 中華醫學會腫瘤學分會, 中華醫學會雜志社. 中華醫學會肺癌臨床診療指南(2018 版). 中華腫瘤雜志, 2018, 40(12): 935.
4. Liu H, Song Y. MDT is still important in the treatment of early stage lung cancer. J Thorac Dis, 2018, 10(Suppl 33): S3984-S3985.
5. 霍小東, 于振濤. 多學科團隊在食管癌診斷與治療中的作用. 中國腫瘤臨床, 2016, 43(12): 502-506.
6. 岳東升, 張華天. 非小細胞肺癌術后輔助治療中國胸外科專家共識(2018 版). 中國肺癌雜志, 2018, 21(10): 14-20.
7. 陸小英, 趙存鳳, 張婷婷, 等. “長海痛尺”在疼痛評估中的應用. 解放軍護理雜志, 2003, 20(4): 6-7.
8. Barratt SL, Morales M, Spiers T, et al. Specialist palliative care, psychology, interstitial lung disease (ILD) multidisciplinary team meeting: a novel model to address palliative care needs. BMJ Open Respir Res, 2018, 5(1): e000360.
9. 張曉利. 泌尿腫瘤 MDT 中國創新模式“成長記”. 中國醫院院長, 2018, (23): 42-44.
10. Mokhles S, Nuyttens JJME, De Mol M, et al. Treatment selection of early stage non-small cell lung cancer: the role of the patient in clinical decision making. BMC Cancer, 2018, 18(1): 79.
11. 袁瑛, 徐棟, 楊琦, 等. 直腸癌伴同時性多發性肺轉移患者的多學科臨床決策探討. 中國腫瘤臨床, 2017, 44(19): 973-978.
12. Gandamihardja TAK, Soukup T, Mcinerney S, et al. Analysing breast cancer multidisciplinary patient management: a prospective observational evaluation of team clinical decision-making. World J Surg, 2018: 1-8.
13. 韋淑貞, 山順林. 非小細胞肺癌多學科治療的新進展. 現代腫瘤醫學, 2010, 18(4): 828-830.
14. Bydder S, Nowak A, Marion K, et al. The impact of case discussion at a multidisciplinary team meeting on the treatment and survival of patients with inoperable non-small cell lung cancer. Inter Med J, 2010, 39(12): 838-841.
15. Emily S, Nicole R, Stephen K, et al. Does presentation at multidisciplinary team meetings improve lung cancer survival? Findings from a consecutive cohort study. Lung Cancer, 2018, 124: 199-204.
16. Connolly MJ, Broad JB, Bish T, et al. Reducing emergency presentations from long-term care: A before-and-after study of a multidisciplinary team intervention. Maturitas, 2018, 117: 45-50.
17. 朱云柯, 林琳, 劉倫旭, 等. 中國胸外科圍手術期疼痛管理專家共識(2018 版). 中國胸心血管外科臨床雜志, 2018, 25(11): 921-928.
18. Burden M, Thornton M. Reducing the risks of surgical site infection: the importance of the multidisciplinary team. Br J Nursing, 2018, 27(17): 976-979.
19. 曹雄, 藺瑞江, 李仁鵬, 等. 多學科診療模式在非小細胞肺癌手術治療過程中的應用價值. 中國胸心血管外科臨床雜志, 2019, 26(8): 780-783.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Analysis of the multidisciplinary team in the surgical treatment of lung cancer by video-assisted thoracoscopic surgery

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