Published online Apr 26, 2024. doi: 10.12998/wjcc.v12.i12.2040
Peer-review started: November 12, 2023
First decision: January 30, 2024
Revised: February 25, 2024
Accepted: March 15, 2024
Article in press: March 15, 2024
Published online: April 26, 2024
Processing time: 154 Days and 18.4 Hours
Lung cancer is the leading cause of death worldwide, and non-small cell lung cancer (NSCLC) in the elderly accounts for a significant proportion. With the significant growth of the aging population, the need for surgical treatment of elderly patients has gradually become more prominent. Video-assisted thoracic surgery (VATS) has become an important choice for the treatment of senile NSCLC due to its characteristics of less trauma and rapid recovery. However, current sys
The aim of this study was to investigate the potential enhancement of VATS in postoperative recovery in elderly patients with NSCLC.
This study was designed to investigate the clinical outcomes of enhanced recovery after surgery (ERAS) in the perioperative period in elderly patients with NSCLC.
We retrospectively analysed the clinical data of 85 elderly NSCLC patients who underwent ERAS (the ERAS group) and 327 elderly NSCLC patients who received routine care (the control group) after VATS at the Department of Thoracic Surgery of Peking University Shenzhen Hospital between May 2015 and April 2017. After propensity score matching of baseline data, we analysed the postoperative stay, total hospital expenses, postoperative 48-hour pain score, and post
After propensity score matching, ERAS significantly reduced the postoperative hospital stay (6.96 ± 4.16 vs 8.48 ± 4.18 d, P = 0.001) and total hospital expenses (48875.27 ± 18437.5 vs 55497.64 ± 21168.63 CNY, P = 0.014) and improved the satisfaction score (79.8 ± 7.55 vs 77.35 ± 7.72, P = 0.029) relative to those for routine care. No significant between-group difference was observed in postoperative 48-h pain score (4.68 ± 1.69 vs 5.28 ± 2.1, P = 0.090) or postoperative compli
ERAS effectively reduced the postoperative hospital stay and total hospital expenses and improved the satisfaction score in the perioperative period for elderly NSCLC patients who underwent lobectomy but not for patients who underwent sublobar resection.
We look forward to more large-sample, multicenter studies to validate the recovery benefits of VATS in elderly patients with NSCLC and to further clarify the safety and effectiveness of the surgical technique. At the same time, combined with biological markers and imaging techniques, the specific mechanism of VATS on postoperative inflammatory response, immune function, and quality of life in elderly patients was further studied. With the help of advanced technical means, the individual differences of elderly patients were finely delineated to provide a more accurate basis for personalized surgical treatment. In addition, the long-term efficacy and survival rate of VATS in elderly patients were evaluated through long-term follow-up to comprehensively understand the long-term impact of surgery. These future research directions will provide an in-depth and comprehensive understanding for further promoting the development of surgical treatment for elderly NSCLC.