[Application of the standardized protocol for fast track recovery after lung cancer surgery]. / Rezul'taty primeneniia standartizovannogo protokola uskorennogo vyzdorovleniia posle onkologicheskikh operatsii na legkom.

OBJECTIVE: To assess standardized protocol for fast track recovery after lung cancer surgery. MATERIAL AND METHODS: There were 201 patients. Patients underwent VATS lung resection, VATS lobectomy and various open resections of lungs. Patients had either primary lung cancer or metastatic lung lesion with indications for surgical treatment. Management of patients was divided into 3 periods: preoperative, intraoperative and postoperative. The protocol of fast track recovery was developed considering literature data and own experience. Requirements of this protocol were applied in perioperative management. RESULTS: Application of the protocol was successful in all patients. Minimum number of complications (6%) and length of postoperative hospital-stay of 4 days were observed after VATS resection of lung. VATS lobectomy was followed by complication rate 25% and postoperative hospital-stay of 6 days. In the group of open resections these values were 29% and 7 days.

[Thoracoscopic pulmonary resection for metastatic lesion without pleural drainage: initial experience]. / Torakoskopicheskie rezektsii legkogo pri metastaticheskom porazhenii bez ustanovki plevral'nogo drenazha: nachal'nyi opyt.

AIM: To analyze the possibility of thoracoscopic pulmonary resection for metastatic lesion without pleural drainage. MATERIAL AND METHODS: There were 10 patients aged 53.8 years. Most of patients had solitary lung injury within 3 cm from the visceral pleura on the average. Surgical treatment was performed in standard fashion: hardware atypical pulmonary resection within healthy tissues. Pleural cavity was drained with 24 Fr tube. After that lung was inflated under visual control. Since wounds were closured residual air was evacuated by active aspiration and drainage tube was removed. Control chest X-ray was performed in 2 hours and 1 day after surgery. RESULTS: The technique was successful in all patients. Mean surgery time was 52 minutes. There was no blood loss in all patients. Pneumo- and/or hydrothorax were absent according to control chest X-ray in postoperative period. Mean length of postoperative hospital-stay was 3 days (median 2 days). There were no cases of repeated hospitalization.