New Protocols Enable Patients to Return Home Safely 1 Day After Lung Cancer Surgery

Researchers found that an increasing number of patients undergoing cancer-removal lung surgery are able to return home safely and free of complications due to the growing rate of robot-assisted surgeries and implementation of enhanced protocols. However, the research also showed that patients of lower socioeconomic status are less likely to be discharged on postoperative day 1 (POD1).

“We believe this is the first study to explore the impact of socioeconomic factors on POD1 discharge in this patient population,” said Dan Nguyen, MD, of the Sylvester Thoracic Cancers Group and senior author of the study, which was published in the Journal of Thoracic and Cardiovascular Surgery Open.

“We found that economic deprivation severely affects the ability to be discharged home the day following surgery, an observation that provides future direction for research and the development of improved care strategies and interventions,” added Dr. Nguyen via a press release.

The guidelines, called enhanced recovery after thoracic surgery (ERATS) protocols, were first introduced in 2018. An updated version was released in 2020. The protocols emphasize an enhanced postoperative recovery period, particularly as it pertains to effective opioid-sparing pain control and reduction of complications.

This study comprised findings from 279 patients whose treatment took place during the latest protocol period. POD1 discharge was defined as a byproduct of ERATS.

According to the authors, the following factors expedite postoperative discharge: expedited drain removal, better opioid-sparing pain control, preoperative counseling to discuss realistic postoperative expectations and home care arrangements, and regular follow-up phone calls by nurse practitioners to encourage patients and monitor their progress.

“We were able to identify a variety of factors that can be mitigated to facilitate POD1 discharge, and we have instituted strategies to address them,” Dr. Nguyen said.