Influencing factors analysis of thoracic drainage time after da Vinci robot lung cancer surgery and preventive solution_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

YANG Zilin ¹ , XU Wei ² , XU Shiguang ² , LIU Bo ² , LIU Dazhi ² , MENG Hao ² , DING Renquan ² , WANG Xilong ² , LIU Xingchi ² , LI Bo ² ,  WANG Shumin ²

1. Graduate Training Base of General Hospital of Northern Theater Command, Jinzhou Medical University, Shenyang, 110016, P.R.China;
2. Department of Thoracic Surgery, General Hospital of Northern Theater Command, Shenyang, 110016, P.R.China;

Corresponding?author：

WANG Shumin, Email: sureman2003congo@163.com

Keywords：

da Vinci robot surgery system; lung cancer; thoracic drainage; postoperative drainage time; enhanced recovery

DOI：

10.7507/1007-4848.202010071

Video：

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Objective To explore the factors that affect the drainage time of da Vinci robot lung cancer surgery, to analyze the coping strategies, and to provide a basis for shortening the drainage time of patients after surgery and speeding up the patients' recovery.Methods The clinical data of 131 patients who underwent da Vinci robot lung cancer surgery at the Department of Thoracic Surgery, General Hospital of Northern Theater Command from January 2019 to October 2019 were retrospectively analyzed. Among them, 68 were males and 63 were females, with an average age of 59.84±9.66 years. According to the postoperative thoracic drainage time, the patients were divided into two groups including a group A (drainage time≤ 5 days) and a group B (drainage time >5 days). Univariate analysis and logistic multivariate regression analysis were used to analyze the factors that may affect postoperative drainage time, and the correlation between different influencing factors and thoracic drainage time after da Vinci robot lung cancer surgery.Results Logistic multivariate analysis showed that age≥60 years (P=0.014), diabetes mellitus (P=0.035), operation time≥130 min (P=0.018), number of lymph node dissections≥15 (P=0.002), and preoperative albumin<38.45 g/L (P=0.010) were independent factors affecting the drainage time of da Vinci robot lung cancer surgery.Conclusion For elderly patients with diabetes mellitus during the perioperative period, blood glucose should be actively controlled, reasonable surgical strategies should be formulated to ensure the safety and effectiveness of the operation, while reducing intraoperative damage and shortening the operation time. After the operation, patients should be guided to strengthen active coughing, expectoration and lung expansion. Thereby it can shorten drainage time and speed up the recovery of patients after operation.

Citation： YANG Zilin, XU Wei, XU Shiguang, LIU Bo, LIU Dazhi, MENG Hao, DING Renquan, WANG Xilong, LIU Xingchi, LI Bo, WANG Shumin. Influencing factors analysis of thoracic drainage time after da Vinci robot lung cancer surgery and preventive solution. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2021, 28(5): 524-528. doi: 10.7507/1007-4848.202010071 Copy

1.	Helminen O, Valo J, Andersen H, et al. Extended resections and other special cases in lung cancer surgery: Real-world population-based outcomes. Thorac Cancer, 2020, 11(10): 2932-2940.
2.	王澤洲, 張揚, 莫淼, 等. 大型單中心醫院登記的 7753 例肺癌手術患者生存報告: 基于第 8 版國際肺癌 TNM 分期標準. 中國癌癥雜志, 2020, 30(5): 321-327.
3.	成興華, 楊運海, 羅清泉. 局部進展期非小細胞肺癌——機器人輔助胸腔鏡手術的下一個戰場? 中華胸部外科電子雜志, 2020, 7(3): 131-134.
4.	Kanzaki M. Current status of robot-assisted thoracoscopic surgery for lung cancer. Surg Today, 2019, 49(10): 795-802.
5.	Deng B, Qian K, Zhou JH, et al. Optimization of chest tube management to expedite rehabilitation of lung cancer patients after video-assisted thoracic surgery: A meta-analysis and systematic review. World J Surg, 2017, 41(8): 2039-2045.
6.	Batchelor TJP, Ljungqvist O. A surgical perspective of ERAS guidelines in thoracic surgery. Curr Opin Anaesthesiol, 2019, 32(1): 17-22.
7.	劉星池, 許世廣, 劉博, 等. Ⅰ 期非小細胞肺癌達芬奇機器人手術的療效分析. 中國肺癌雜志, 2018, 21(11): 849—856.
8.	Hu X, Wang M. Efficacy and safety of robot-assisted thoracic surgery (RATS) compare with video-assisted thoracoscopic surgery (VATS) for lung lobectomy in patients with non-small cell lung cancer. Comb Chem High Throughput Screen, 2019, 22(3): 169-178.
9.	Li S, Zhou K, Che G, et al. Enhanced recovery programs in lung cancer surgery: Systematic review and meta-analysis of randomized controlled trials. Cancer Manag Res, 2017, 9: 657-670.
10.	Shi Q, Diao Y, Qian J. Application of single-hole thoracoscopic surgery combined with ERAS concept for respiratory function exercise in perioperative period of lung cancer. Zhongguo Fei Ai Za Zhi, 2020, 23(8): 667-672.
11.	Lin C, Wan F, Lu Y, et al. Enhanced recovery after surgery protocol for prostate cancer patients undergoing laparoscopic radical prostatectomy. J Int Med Res, 2019, 47(1): 114-121.
12.	Jeong O, Kim HG. Implementation of enhanced recovery after surgery (ERAS) Program in perioperative management of gastric cancer surgery: A nationwide survey in Korea. J Gastric Cancer, 2019, 19(1): 72-82.
13.	Gonzalez M, Abdelnour-Berchtold E, Perentes JY, et al. An enhanced recovery after surgery program for video-assisted thoracoscopic surgery anatomical lung resections is cost-effective. J Thorac Dis, 2018, 10(10): 5879-5888.
14.	Howington JA, Blum MG, Chang AC, et al. Treatment of stage Ⅰ and Ⅱ non-small cell lung cancer: Diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest, 2013, 143(5 Suppl): e278S-e313S.
15.	Eichhorn F, Klotz LV, Muley T, et al. Prognostic relevance of regional lymph-node distribution in patients with N1-positive non-small cell lung cancer: A retrospective single-center analysis. Lung Cancer, 2019, 138: 95-101.
16.	Riquet M, Rivera C, Pricopi C, et al. Is the lymphatic drainage of lung cancer lobe-specific? A surgical appraisal. Eur J Cardiothorac Surg, 2015, 47(3): 543-549.

1. Helminen O, Valo J, Andersen H, et al. Extended resections and other special cases in lung cancer surgery: Real-world population-based outcomes. Thorac Cancer, 2020, 11(10): 2932-2940.
2. 王澤洲, 張揚, 莫淼, 等. 大型單中心醫院登記的 7753 例肺癌手術患者生存報告: 基于第 8 版國際肺癌 TNM 分期標準. 中國癌癥雜志, 2020, 30(5): 321-327.
3. 成興華, 楊運海, 羅清泉. 局部進展期非小細胞肺癌——機器人輔助胸腔鏡手術的下一個戰場? 中華胸部外科電子雜志, 2020, 7(3): 131-134.
4. Kanzaki M. Current status of robot-assisted thoracoscopic surgery for lung cancer. Surg Today, 2019, 49(10): 795-802.
5. Deng B, Qian K, Zhou JH, et al. Optimization of chest tube management to expedite rehabilitation of lung cancer patients after video-assisted thoracic surgery: A meta-analysis and systematic review. World J Surg, 2017, 41(8): 2039-2045.
6. Batchelor TJP, Ljungqvist O. A surgical perspective of ERAS guidelines in thoracic surgery. Curr Opin Anaesthesiol, 2019, 32(1): 17-22.
7. 劉星池, 許世廣, 劉博, 等. Ⅰ 期非小細胞肺癌達芬奇機器人手術的療效分析. 中國肺癌雜志, 2018, 21(11): 849—856.
8. Hu X, Wang M. Efficacy and safety of robot-assisted thoracic surgery (RATS) compare with video-assisted thoracoscopic surgery (VATS) for lung lobectomy in patients with non-small cell lung cancer. Comb Chem High Throughput Screen, 2019, 22(3): 169-178.
9. Li S, Zhou K, Che G, et al. Enhanced recovery programs in lung cancer surgery: Systematic review and meta-analysis of randomized controlled trials. Cancer Manag Res, 2017, 9: 657-670.
10. Shi Q, Diao Y, Qian J. Application of single-hole thoracoscopic surgery combined with ERAS concept for respiratory function exercise in perioperative period of lung cancer. Zhongguo Fei Ai Za Zhi, 2020, 23(8): 667-672.
11. Lin C, Wan F, Lu Y, et al. Enhanced recovery after surgery protocol for prostate cancer patients undergoing laparoscopic radical prostatectomy. J Int Med Res, 2019, 47(1): 114-121.
12. Jeong O, Kim HG. Implementation of enhanced recovery after surgery (ERAS) Program in perioperative management of gastric cancer surgery: A nationwide survey in Korea. J Gastric Cancer, 2019, 19(1): 72-82.
13. Gonzalez M, Abdelnour-Berchtold E, Perentes JY, et al. An enhanced recovery after surgery program for video-assisted thoracoscopic surgery anatomical lung resections is cost-effective. J Thorac Dis, 2018, 10(10): 5879-5888.
14. Howington JA, Blum MG, Chang AC, et al. Treatment of stage Ⅰ and Ⅱ non-small cell lung cancer: Diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest, 2013, 143(5 Suppl): e278S-e313S.
15. Eichhorn F, Klotz LV, Muley T, et al. Prognostic relevance of regional lymph-node distribution in patients with N1-positive non-small cell lung cancer: A retrospective single-center analysis. Lung Cancer, 2019, 138: 95-101.
16. Riquet M, Rivera C, Pricopi C, et al. Is the lymphatic drainage of lung cancer lobe-specific? A surgical appraisal. Eur J Cardiothorac Surg, 2015, 47(3): 543-549.

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Influencing factors analysis of thoracic drainage time after da Vinci robot lung cancer surgery and preventive solution

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