periOPTIME - The New Kid on the Block - A Refined Enhanced Recovery Program

Background
With the advent of enhanced recovery programs (ERP) length of hospital stay (LoS) were shortened substantially. However, program refinements may have additional impact. Patients participating with periOPTIME are motivated to stay active during the preoperative period and profit from streamlined referrals to specialist counselling.


Aims
The program aims for minimal invasive approaches and strict reduction of unneeded examinations with emphasis on enhancing patient experience and QoL


Methods
Patients undergoing anatomical lung resection between May 2022 - December 2024 are treated within a modified ERP and compared to a historical control group (2018-2020).
To study prospectively the effect of a modified enhanced recovery program within a patient population undergoing anatomic lung resection. The primary objective is to assess LoS. Preliminary data from May - November 2022 was analysed.


Results
The preliminary analysis included 19 patients with 58% male and 42% female participants and median age of 65 years. Most participants suffered from NSCLC (N=16) including UICC stage I-IV, followed by patients with Metastasis from other primary tumors (N=2) and one case with Cryptogenic Organising Pneumonia. Resections were scheduled as RATS (42%) or VATS (58%). Two VATS UL resections were converted to open surgery. Median LoS was 4 days (2-17) compared to 9 days in the historical group for VATS/RATS lobectomy. Open surgery was related to higher LoS. No major complications related to the study protocol occurred. Main reasons for prolonged LoS was airleak (N=5), chylothorax (N=1), pleural effusion (N=1) and social reasons (N=2). Median time to first mobilisation in the ERP group was 7 hours (3-24; sd=7.4). Median time for thoracic drainage was 23 hours (17-360; sd=90)


Conclusion
Preliminary data showed a shorter LoS in the ERP group, without the occurrence of major complications. The sample is too small to detect significant change in LoS. However, the results are promising.