The influence of ERAS recommendation implementation in surgical treatment of spontaneous pneumothorax in women
DOI:
https://doi.org/10.15574/PP.2025.1(101).8289Keywords:
spontaneous pneumothorax, non-intubated video-assisted thoracic surgery, video-assisted thoracoscopic surgery, enhanced recovery after surgery, womenAbstract
Spontaneous pneumothorax sometimes is life threatening condition which accounts from 1.2 to 15.4 cases per 100,000 of the women per year.
Aim: to analysis of results after implementation of ERAS protocols in treatment of spontaneous pneumothorax in women of different age groups for optimizing the tactic of treatment
Materials and methods. Prospective study was performed on 80 patients, age 22-62 years with spontaneous pneumothorax, were divided on 2 groups. In control group (n=40) standard perioperative treatment was performed, in main group (n=40) uniportal non-intubated video-assisted thoracic surgery with multimodal analgesia techniques and implemented ERAS components by our team. The analysis of effectiveness of different components of ERAS in preoperative, intraoperative, postoperative phases were compared in two groups. Statistic analysis was performed with «SPSS 21» program.
Results. It was established that time to decision for surgical treatment, surgery during first 48 hours from admission, not applying premedication, surgery during mensis, prophylaxis of postoperative nausea and vomiting, applying of BIS-monitoring, warming patient through the whole perioperative time, postoperative pain, time for first meal after surgery, early mobilization, number of postoperative chest X-rays before chest drain removal were statistically significant.
Conclusions. Proposed and implemented ERAS recommendations in treatment of spontaneous pneumothorax in women reduced the time to discharge criteria by 3.47 days and the length of hospital stay by 3.42 days.
The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of participating institution. The informed consent of the patient was obtained for conducting the studies.
No conflict of interest was declared by the authors.
References
Bobbio A, Canny E, Mansuet Lupo A, Lococo F, Legras A, Magdeleinat P et al. (2017). Thoracic Endometriosis Syndrome Other Than Pneumothorax: Clinical and Pathological Findings. Ann Thorac Surg. 104(6): 1865-1871. https://doi.org/10.1016/j.athoracsur.2017.06.049; PMid:29054304
Brindle M, Nelson G, Lobo DN, Ljungqvist O, Gustafsson UO. (2020). Recommendations from the ERAS® Society for standards for the development of enhanced recovery after surgery guidelines. BJS Open. 4(1): 157-163. Epub 2019 Dec 2. https://doi.org/10.1002/bjs5.50238; PMid:32011810 PMCid:PMC6996628
Cerfolio RJ, Pickens A, Bass C, Katholi C. (2001). Fast-tracking pulmonary resections. J Thorac Cardiovasc Surg. 122(2): 318-324. https://doi.org/10.1067/mtc.2001.114352; PMid:11479505
Comelli I, Bologna A, Ticinesi A, Magnacavallo A, Comelli D et al. (2017). Incidence of primary spontaneous pneumothorax is not associated with microclimatic variations. Results of a seven-year survey in a temperate climate area. Monaldi Arch Chest Dis. 87(1): 793. https://doi.org/10.4081/monaldi.2017.793; PMid:28635192
Elias KM, Brindle ME, Nelson G. (2025). Enhanced Recovery after Surgery - Evidence and Practice. NEJM Evid. 4(3): EVIDra2400012. https://doi.org/10.1056/EVIDra2400012; PMid:39998302
Elias KM, Stone AB, McGinigle K, Tankou JI, Scott MJ, Fawcett WJ et al. (2019). The Reporting on ERAS Compliance, Outcomes, and Elements Research (RECOvER) Checklist: A Joint Statement by the ERAS® and ERAS® USA Societies. World J Surg. 43(1): 1-8. https://doi.org/10.1007/s00268-018-4753-0; PMid:30116862 PMCid:PMC6313353
Gottschalk A, Smith DS. (2001). New concepts in acute pain therapy: preemptive analgesia. Am Fam Physician. 63(10): 1979-1984.
Gu Y, Hao J, Wang J, Liang P, Peng X, Qin X et al. (2024). Effectiveness Assessment of Bispectral Index Monitoring Compared with Conventional Monitoring in General Anesthesia: A Systematic Review and Meta-Analysis. Anesthesiol Res Pract. 2024: 5555481. https://doi.org/10.1155/2024/5555481; PMid:39149130 PMCid:PMC11325011
Hewson DW, Tedore TR, Hardman JG. (2024). Impact of spinal or epidural anaesthesia on perioperative outcomes in adult noncardiac surgery: a narrative review of recent evidence. Br J Anaesth. 133(2): 380-399. Epub 2024 May 28. https://doi.org/10.1016/j.bja.2024.04.044; PMid:38811298 PMCid:PMC11282476
Horn A, Kaneshiro K, Tsui BCH. (2020). Preemptive and Preventive Pain Psychoeducation and Its Potential Application as a Multimodal Perioperative Pain Control Option: A Systematic Review. Anesth Analg. 130(3): 559-573. https://doi.org/10.1213/ANE.0000000000004319; PMid:31335400
Huang L, Kehlet H, Petersen RH. (2024). Readmission after enhanced recovery video-assisted thoracoscopic surgery wedge resection. Surg Endosc. 38(4): 1976-1985. https://doi.org/10.1007/s00464-024-10700-6; PMid:38379006 PMCid:PMC10978727
Hwong TM, Ng CS, Lee TW, Wan S, Sihoe AD, Wan IY et al. (2004). Video-assisted thoracic surgery for primary spontaneous hemopneumothorax. Eur J Cardiothorac Surg. 26(5): 893-896. https://doi.org/10.1016/j.ejcts.2004.05.014; PMid:15519178
Joshi GP, Kehlet H. (2019). Enhanced Recovery Pathways: Looking Into the Future. Anesth Analg. 128(1): 5-7. https://doi.org/10.1213/ANE.0000000000003746; PMid:30550467
Joshi GP. (2021). General anesthetic techniques for enhanced recovery after surgery: Current controversies. Best Pract Res Clin Anaesthesiol. 35(4): 531-541. https://doi.org/10.1016/j.bpa.2020.08.009; PMid:34801215
Kehlet H, Lobo DN. (2024). Exploring the need for reconsideration of trial design in perioperative outcomes research: a narrative review. EClinicalMedicine. 70: 102510. https://doi.org/10.1016/j.eclinm.2024.102510; PMid:38444430 PMCid:PMC10912044
McDaid C, Maund E, Rice S, Wright K, Jenkins B, Woolacott N. (2010). Paracetamol and selective and non-selective non-steroidal anti-inflammatory drugs (NSAIDs) for the reduction of morphine-related side effects after major surgery: a systematic review. Health Technol Assess. 14(17): 1-153, III-IV. https://doi.org/10.3310/hta14170; PMid:20346263
Nilsson U, Gruen R, Myles PS. (2020). Postoperative recovery: the importance of the team. Anaesthesia. 75; Suppl 1: e158-e164. https://doi.org/10.1111/anae.14869; PMid:31903575
Novitsky YW, Litwin DE, Callery MP. (2004). The net immunologic advantage of laparoscopic surgery. Surg Endosc. 18(10): 1411-1419. https://doi.org/10.1007/s00464-003-8275-x; PMid:15791361
Oliver CM, Warnakulasuriya S, McGuckin D, Singleton G, Martin P, Santos C et al. (2022). Delivery of drinking, eating and mobilising (DrEaMing) and its association with length of hospital stay after major noncardiac surgery: observational cohort study. Br J Anaesth. 129(1): 114-126. https://doi.org/10.1016/j.bja.2022.03.021; PMid:35568508 PMCid:PMC9284668
Roberts ME, Rahman NM, Maskell NA, Bibby AC, Blyth KG, Corcoran JP et al. (2023). British Thoracic Society Guideline for pleural disease. Thorax. 78; Suppl 3: s1-s42. https://doi.org/10.1136/thorax-2022-219784; PMid:37433578
Rollins KE, Lobo DN, Joshi GP. (2021). Enhanced recovery after surgery: Current status and future progress. Best Pract Res Clin Anaesthesiol. 35(4): 479-489. https://doi.org/10.1016/j.bpa.2020.10.001; PMid:34801211
Sahn SA, Heffner JE. (2000). Spontaneous pneumothorax. N Engl J Med. 342(12): 868-874. https://doi.org/10.1056/NEJM200003233421207; PMid:10727592
Sauro KM, Smith C, Ibadin S, Thomas A, Ganshorn H, Bakunda L et al. (2024). Enhanced Recovery After Surgery Guidelines and Hospital Length of Stay, Readmission, Complications, and Mortality: A Meta-Analysis of Randomized Clinical Trials. JAMA Netw Open. 7(6): e2417310. https://doi.org/10.1001/jamanetworkopen.2024.17310; PMid:38888922 PMCid:PMC11195621
Slim K, Joris J. (2017). The egg-and-chicken situation in postoperative enhanced recovery programmes. Br J Anaesth. 118(1): 5-6. https://doi.org/10.1093/bja/aew408; PMid:28039235
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Ukrainian Journal of Perinatology and Pediatrics
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
The policy of the Journal “Ukrainian Journal of Perinatology and Pediatrics” is compatible with the vast majority of funders' of open access and self-archiving policies. The journal provides immediate open access route being convinced that everyone – not only scientists - can benefit from research results, and publishes articles exclusively under open access distribution, with a Creative Commons Attribution-Noncommercial 4.0 international license(СС BY-NC).
Authors transfer the copyright to the Journal “MODERN PEDIATRICS. UKRAINE” when the manuscript is accepted for publication. Authors declare that this manuscript has not been published nor is under simultaneous consideration for publication elsewhere. After publication, the articles become freely available on-line to the public.
Readers have the right to use, distribute, and reproduce articles in any medium, provided the articles and the journal are properly cited.
The use of published materials for commercial purposes is strongly prohibited.
