Abstract

COLLADO OTERO, Juan Carlos; PAREDES LOPEZ, Dagmar; VAZQUEZ GONZALEZ, José  and  DANTA FUNDORA, Debora. Results from pulmonary surgery performed in Cuban National Institute of Oncology and Radiobiology (2006-2007). Rev Cubana Cir [online]. 2009, vol.48, n.2, pp. 0-0. ISSN 1561-2945.

INTRODUCTION: To reduce intensive care stay and that of postoperative hospital stay in pulmonary surgery service with a minimal morbidity and mortality becomes in a real research trend for most of thoracic surgery service at world scale. Aim of this paper was to assess results of quality and effectiveness in a thoracic surgery service. METHODS: During a period of 2 years we performed consecutive pulmonary resections by thoracotomy and patients underwent extubation in operating room and referred during the first 24 hours to a progressive care ward. Thoracic tubes were placed with water seal and removed at third postoperative day if there was not an aerial escape and if drain was smaller than 150 mL/day. We used a epidural catheter removed at second postoperative day. Patient was discharged the same day of removed the last tube. RESULTS: At present study were included 156 patients (men) with a mean age of 58 years (rank, 21-78 years). In 9 of them a pneumonectomy was performed (6%) and lobectomy and bi-lobectomy in 110 patients (71%). Extra-anatomical resections were used for metastasectomies. One hundred ninety nine patients (96%) underwent extubation in operating room, and 112 of them (72%) were sending during the first hours to a progressive care unit. There were complications in 28 patients (18%), and operative mortality was of 5% (8 patients). Postoperative mean stay was of 4 days (rank, 2-25 days). Ninety nine patients (64%) were discharged at forth postoperative day or before. The 97% reported an excellent or good satisfaction degree. CONCLUSIONS: Most of patients could be immediately underwent extubation at operating room, they went directly to ward or needed minimal progressive cares and were discharged at third or fourth postoperative day. Morbidity and mortality were acceptable with a high level of satisfaction at discharge and at follow-up in ambulatory consultation 2 weeks after discharge. Techniques allow us to achieve these results included systematic use of water seal, removal of epidural catheter at 2^nd postoperative day and early management of thoracic tubes.

Keywords : Pulmonary resections; short stay; fast tracking lobectomy..

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