Enhanced recovery after lung cancer surgery: a prospective cohort study of individualized perioperative management

INTRODUCTION Enhanced Recovery After Surgery (ERAS) protocols are increasingly used in lung cancer surgery (LCS), but evidence regarding individualized ERAS-based perioperative management remains limited.AIM This study evaluated the effectiveness of individualized ERAS-based perioperative management in improving postoperative recovery, reducing complications, and enhancing patient satisfaction fol lowing radical LCS. MATERIALS AND METHODSA total of 138 patients undergoing radical LCS were allocated to either con ventional perioperative nursing care (n = 69) or individualized ERAS-based perioperative management (n = 69).The outcomes associated with postoperative recovery included ambulation, gastrointestinal recovery, oral intake, chest tube drainage duration, and length of hospital stay (LOS).Additionally, post operative pain, complications, and patient satisfaction were evaluated. RESULTSThe individualized ERAS based perioperative management group showed earlier postopera tive ambulation, faster gastrointestinal recovery, earlier oral intake, shorter chest tube duration, lower postoperative pain scores, and reduced LOS, as compared with the controls (P <0.001).The overall postoperative complication rate was lower in the individualized ERAS-based perioperative management cohort than in the control group (13% vs 26.1%; P = 0.048).Multivariable linear regression demonstrated that individualized ERAS-based perioperative management was independently associated with shorter LOS (β = -1.42;95% CI, -2.17 to -0.68; P <0.001).CONCLUSIONS Individualized ERAS-based perioperative management was associated with earlier postoperative recovery, lower postoperative pain, a lower overall postoperative complication rate, and shorter LOS, as compared with conventional perioperative care.These findings support further prospec tive evaluation of individualized ERAS-based strategies in patients undergoing LCS.