Analysis of influencing factors for prolonged postoperative hospital stay after Da Vinci robot-assisted mediastinal tumor resection with non-endotracheal intubation and the process optimization
- VernacularTitle:机器人辅助非气管插管纵隔肿瘤切除术后住院时间延长的影响因素分析及流程优化
- Author:
Shiyuan SONG
1
,
2
;
Ziheng WU
3
,
4
;
Wei XU
3
;
Qiong WU
3
;
Shiguang XU
3
;
Bo LIU
3
;
Renquan DING
3
;
Xilong WANG
3
;
Yuhang HU
3
;
Shumin WANG
3
Author Information
1. 1. Graduate Training Base of General Hospital of Northern Theater Command, Dalian Medical University, Shenyang, 110016, P. R. China
2. 2. Department of Thoracic Surgery, General Hospital of Northern Theater Command, Shenyang, 110016, P. R. China
3. 2. Department of Thoracic Surgery, General Hospital of Northern Theater Command, Shenyang, 110016, P. R. China
4. 3. Medical College of Zhejiang University, Hangzhou, 310009, P. R. China
- Publication Type:Journal Article
- Keywords:
Totally no tube;
Da Vinci robot surgery system;
mediastinal tumor;
postoperative hospital stay;
enhanced recovery after surgery
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2023;30(10):1396-1401
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the risk factors for postoperative length of stay (PLOS) after mediastinal tumor resection by robot-assisted non-endotracheal intubation and to optimize the perioperative process. Methods The clinical data of patients who underwent Da Vinci robot-assisted mediastinal tumor resection with non-endotracheal intubation at the Department of Thoracic Surgery, General Hospital of Northern Theater Command from 2016 to 2019 were retrospectively analyzed. According to the median PLOS, the patients were divided into two groups. The univariate analysis and multivariate logistic regression were used to analyze risk factors for prolonged PLOS (longer than median PLOS). Results A total of 190 patients were enrolled, including 92 males and 98 females with a median age of 51.5 (41.0, 59.0) years. The median PLOS of all patients was 3.0 (2.0, 4.0) d. There were 71 patients in the PLOS>3 d group and 119 patients in the PLOS≤3 d group. Multivariate logistic regression showed that indwelled thoracic catheter [OR=11.852, 95%CI (2.384, 58.912), P=0.003], preoperative symptoms of muscle weakness [OR=4.814, 95%CI (1.337, 17.337), P=0.016] and postoperative visual analogue scale>5 points [OR=6.696, 95%CI (3.033, 14.783), P<0.001] were independent factors for prolonged PLOS. Totally no tube (TNT) allowed patients to be discharged on the first day after surgery. Conclusion Robot-assisted mediastinal tumor resection with non-endotracheal intubation can promote rapid recovery. The methods of optimizing perioperative process are TNT, controlling muscle weakness symptoms and postoperative pain relief.
