Min Kong1, Hongkui Zheng2, Lulu Ding3, Ke Jin1, Jianfei Shen2, Minhua Ye4, Baofu Chen5. 1. Department of Thoracic Surgery, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Taizhou, China; Department of Thoracic Surgery, Enze Hospital, Taizhou Enze Medical Center (Group), Taizhou, China. 2. Department of Thoracic Surgery, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Taizhou, China. 3. Central Sterile Supply Department, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Taizhou, China. 4. Department of Thoracic Surgery, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Taizhou, China; Department of Thoracic Surgery, Enze Hospital, Taizhou Enze Medical Center (Group), Taizhou, China. ymh@enzemed.com. 5. Department of Thoracic Surgery, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Taizhou, China. chenbf@enzemed.com.
Abstract
BACKGROUND: To evaluate the benefits of perioperative pulmonary rehabilitation training (PPRT) in patients undergoing thoracoscopic lung cancer resection. METHODS: The clinical data of 1,427 patients undergoing thoracoscopic lung cancer resection were collated. Of these patients, 779 received PPRT (the PPRT group), which included systematic education, improvement of posture, diaphragmatic respiration, bilateral lower thoracic expansion, surgical side thoracic local expansion, incentive spirometry training, effective cough training, aerobic walking, and other systematic pulmonary rehabilitation training. The other 648 patients did not receive PPRT (the non-PPRT group). Baseline characteristics including length of hospital stay, cost of hospitalization, and the incidence of postoperative pulmonary complications (PPCs) were assessed. RESULTS: There was no significant difference between the PPRT group and the non- PPRT group in terms of age, gender distribution, tumor location, operation mode, postoperative pathological type, TNM stage, and other baseline characteristics (P>0.05). The complication index of the PPRT group was slightly higher than that of the non-PPRT group (P<0.05). Patients in the PPRT group had significantly fewer postoperative hospitalization days (PHD) {6.1 days [95% confidence interval (CI): 5.8 to 6.4] vs. 6.4 days (95% CI: 6.1 to 6.7), P=0.002}, fewer total hospitalization days (THD) [9.3 days (95% CI: 8.9 to 9.7) vs. 10.8 days (95% CI: 10.3 to 11.3), P=0.000], lower non-surgical expenses (35,024±9,742 vs. 36,831±10,245 RMB), and fewer cases of PPCs) (3.72% vs. 6.33%, P=0.016) compared to patients in the non-PPRT group. In the subgroup analysis, patients less than 60 years old in the PPRT group fared better in terms of the PHDs, total inpatient days, and non-surgical expenses compared to patients in the non-PPRT group (P<0.05). In patients aged 60 years and older, the THDs in the PPRT group was less than that in the non-PPRT group (P<0.05), but there were no significant differences in the PHDs and non-surgical expenses. CONCLUSIONS: PPRT can reduce the cost of medical resources in patients undergoing thoracoscopic lung cancer resection, especially by shortening the length of hospital stay, reducing the cost of hospitalization, and reducing PPCs.
BACKGROUND: To evaluate the benefits of perioperative pulmonary rehabilitation training (PPRT) in patients undergoing thoracoscopic lung cancer resection. METHODS: The clinical data of 1,427 patients undergoing thoracoscopic lung cancer resection were collated. Of these patients, 779 received PPRT (the PPRT group), which included systematic education, improvement of posture, diaphragmatic respiration, bilateral lower thoracic expansion, surgical side thoracic local expansion, incentive spirometry training, effective cough training, aerobic walking, and other systematic pulmonary rehabilitation training. The other 648 patients did not receive PPRT (the non-PPRT group). Baseline characteristics including length of hospital stay, cost of hospitalization, and the incidence of postoperative pulmonary complications (PPCs) were assessed. RESULTS: There was no significant difference between the PPRT group and the non- PPRT group in terms of age, gender distribution, tumor location, operation mode, postoperative pathological type, TNM stage, and other baseline characteristics (P>0.05). The complication index of the PPRT group was slightly higher than that of the non-PPRT group (P<0.05). Patients in the PPRT group had significantly fewer postoperative hospitalization days (PHD) {6.1 days [95% confidence interval (CI): 5.8 to 6.4] vs. 6.4 days (95% CI: 6.1 to 6.7), P=0.002}, fewer total hospitalization days (THD) [9.3 days (95% CI: 8.9 to 9.7) vs. 10.8 days (95% CI: 10.3 to 11.3), P=0.000], lower non-surgical expenses (35,024±9,742 vs. 36,831±10,245 RMB), and fewer cases of PPCs) (3.72% vs. 6.33%, P=0.016) compared to patients in the non-PPRT group. In the subgroup analysis, patients less than 60 years old in the PPRT group fared better in terms of the PHDs, total inpatient days, and non-surgical expenses compared to patients in the non-PPRT group (P<0.05). In patients aged 60 years and older, the THDs in the PPRT group was less than that in the non-PPRT group (P<0.05), but there were no significant differences in the PHDs and non-surgical expenses. CONCLUSIONS: PPRT can reduce the cost of medical resources in patients undergoing thoracoscopic lung cancer resection, especially by shortening the length of hospital stay, reducing the cost of hospitalization, and reducing PPCs.