Impact of fast-track surgery on perioperative care in patients undergoing hepatobiliary surgery

BACKGROUND Fast-track surgery(FTS)is a modern nursing approach that has gained popularity in the perioperative phase of surgery.AIM To investigate the impact of FTS on perioperative care for hepatobiliary surgery.METHODS A retrospective analysis was performed on 98 patients who underwent hepato-biliary surgery and were admitted to our hospital from August 2021 to October 2023.They were divided into an observation group and a control group with 49 patients in each group according to different nursing directions.The control group was treated with standard nursing and the observation group was treated with FTS concept nursing.The length of hospital stay,visual analog scale(VAS)score,wound complications,nursing satisfaction,self-rating scale(SAS)score,and SF-36 quality of life(QoL)score were compared between the two groups before and after care.RESULTS The duration of hospitalization,hospitalization cost,operation time,first im-plantation time,exhaust time,and first defecation time were shorter than the observation group(P<0.05).Additionally,the observation group showed a sig-nificant difference between the VAS and SAS scores on days 1,3,and 7(P<0.05).The complication rate in the observation group was 4.05%was significantly lower than the 18.36%in the control group,and the comparison groups were statistically significant(χ2=5.018,P=0.025).The observation group had a significantly higher level of nurse satisfaction(94.92%)than the control group(79.59%;χ2=6.078,P=0.014).Both groups showed higher QoL scores after nursing care,with higher scores in the observation group than in the control group(P=0.032).CONCLUSION FTS in patients undergoing hepatobiliary surgery can effectively improve negative mood,QoL,and nursing sa-tisfaction;reduce wound complications;and accelerate patient rehabilitation.

Effects of multimodal fast-track surgery on liver transplantation outcomes

BACKGROUND: Fast-track surgery and enhanced recovery after surgery have been applied to many surgical procedures; however, data on fast-track surgery and enhanced recovery after surgery following liver transplantation is limited. This study aimed to conduct a prospective study to determine the effects of fast-track surgery on prognosis after liver transplantation. METHODS: This was a prospective, single-blinded, randomized study. One hundred twenty-eight patients undergoing liver transplantation were selected for the fast-track (FT group, n=54) or conventional process (NFT group, n=74). The primary endpoints were intensive care unit (ICU) stay and hospital stay. The secondary endpoints were as follows: operative time, anhepatic phase time, intraoperative blood loss, intraoperative blood transfusion volume, postoperative complications, readmission rate, and postoperative mortality. RESULTS: There was no significant difference in preoperative demographics between the two groups. The median ICU stay was 2 days (range 1-7 days) in the FT group and 5 days (range 3-12 days) in the NFT group (P<0.01). Furthermore, the hospital stay was also significantly reduced in the FT group (P<0.01). The operative time, anhepatic phase time, intraoperative blood loss, and intraoperative blood transfusion volume were decreased in the FT group compared with the NFT group (P<0.05). Based on Spearman correlation analysis, the ICU stay and hospital stay may be positively correlated with operative time, anhepatic phase time and intraoperative blood loss. There were no differences in the incidence of postoperative complications, readmissions, and postoperative mortality between the two groups. CONCLUSION: Fast-track procedures effectively reduce the ICU stay and hospital stay without adversely affecting prognosis. This study demonstrated that fast-track protocols are safe and feasible in liver transplantation.

Effects of nursing care in fast-track surgery on postoperative pain, psychological state, and patient satisfaction with nursing for glioma

BACKGROUND The brain is the most complex organ in the human body.Treatment for a glioma always involves a multi-disciplinary team.Nursing care in fast-track surgery or enhanced recovery after surgery is such kind of work implemented by an interdisciplinary team to provide services to patients to improve their outcomes.AIM To explore the effects of nursing care in fast-track surgery on postoperative pain,psychological state,and patient satisfaction with nursing for glioma.METHODS From June 2018 to June 2020,138 patients who underwent operation for glioma at Cancer Hospital Affiliated to Chongqing University were selected.They were categorized into groups according to different nursing care that they received.Of them,69 patients receiving nursing care in fast-track surgery were included in an experimental group,and 69 patients receiving conventional postoperative nursing were included in a control group.Visual analogue scale was used to evaluate postoperative pain in the two groups immediately after the operation and at 3 d after the operation.Self-rating anxiety scale(SAS)and self-rating depression scale(SDS)were used to evaluate the psychological status of patients immediately after operation and on the 3rd postoperative day.A self-made satisfaction scale for patient satisfaction with nursing was used to evaluate and compare patient satisfaction with nursing between the two groups.RESULTS Time to excretion,time to out-of-bed activities,and length of hospital stay were significantly shorter in the observation group than in the control group(P<0.05).There was no significant difference in duration of operative time or intraoperative bleeding between the two groups(P>0.05).There was no significant difference in postoperative pain score between the two groups(P>0.05).The pain score was significantly lower in the observation group than in the control group at 3 d after the operation(P<0.05).There was no significant difference in postoperative SAS or SDS score between the two groups(P>0.05).SAS and SDS scores were significantly lower in the observation group than in the control group at 3 d after operation(P<0.05).The rate of patient satisfaction with nursing was 94.2%in the observation group,which was significantly higher than that(81.2%)of the control group(P<0.05).CONCLUSION Nursing care in fast-track surgery can relieve postoperative pain,anxiety,and depression,and improve patient satisfaction with nursing in patients with glioma,which is worthy of clinical application.

Fast-track surgery in elderly patients undergoing colorectal cancer radical resection

Purpose:To investigate the efficacy of applying fast-track surgery(FTS)to elderly patients undergoing radical resection of colorectal cancer.Methods:Elderly patients undergoing radical resection of colorectal cancer received FTS(n=31)or routine(n=31)nursing care.The time to first anal exhaust,oral feeding and leaving the bed,duration of postoperative hospital stay and the incidence of complications were compared between the two groups.Results:Patients receiving FTS nursing demonstrated significantly shorter times to exhaust,oral feeding and leaving the bed compared with those receiving routine nursing(all p<0.01).Furthermore,there were significantly fewer incidences of postoperative pulmonary and urinary tract infections and intestinal adhesion in patients receiving FTS nursing(all p<0.05).Conclusion:Application of FTS in elderly patients undergoing radical resection of colorectal cancer facilitates an early rehabilitation after surgery,but places higher demands on nursing care.

Effect of fast-track surgery in gynecological laparoscopy:a randomized controlled trial

Objective:To evaluate the value of fast-track surgery(FTS)in gynecological laparoscopy during the perioperative period.Methods:The clinical data of 234 patients who underwent gynecological laparoscopy from January to December in 2018 were collected.Of note,117 patients received a routine nursing method(control group),and 117 patients received the FTS nursing method(observation group).Results:Compared with the control group,FTS group had a quicker postoperative bowel function recovery,earlier to get out of bed,and a lower anxiety level(P<0.05);The incidence of postoperative nausea and vomiting of two groups had no statistical difference.Conclusions:The application of FTS in gynecological laparoscopy is safe,effective,and worth promoting.

Research Progress on the Application of Fast-track Surgery in Perioperative Nursing

Fast-track surgery is a combination of multiple disciplines,using a series of evidence-based medical measures to promote the recovery of gastrointestinal function,reduce complications and promote the rapid recovery of patients.The concept of accelerated rehabilitation runs through the whole process before,during and after operation,and the perioperative surgical nursing plan is improved,which is expected to provide reference for medical staff to carry out perioperative nursing.

Fast-track surgery could improve postoperative recovery in radical total gastrectomy patients

AIM: To assess the impact of fast-track surgery (FTS) on hospital stay, cost of hospitalization and complications after radical total gastrectomy. METHODS: A randomized, controlled clinical trial was conducted from November 2011 to August 2012 in the Department of Digestive Surgery, Xijing Hospital of Digestive Diseases, the Fourth Military Medical University. A total of 122 gastric cancer patients who met the selection criteria were randomized into FTS and conventional care groups on the first day of hospitalization. All patients received elective standard D2 total gastrectomy. Clinical outcomes, including duration of flatus and defecation, white blood cell count, postoperative pain, duration of postoperative stay, cost of hospitalization and complications were recorded and evaluated.Two specially trained doctors who were blinded to the treatment were in charge of evaluating postoperative outcomes, discharge and follow-up. RESULTS: A total of 119 patients finished the study, including 60 patients in the conventional care group and 59 patients in the FTS group. Two patients were excluded from the FTS group due to withdrawal of consent. One patient was excluded from the conventional care group because of a non-resectable tumor. Compared with the conventional group, FTS shortened the duration of flatus (79.03 ± 20.26 hvs 60.97 ± 24.40 h, P = 0.000) and duration of defecation (93.03 ± 27.95 h vs 68.00 ± 25.42 h, P = 0.000), accelerated the decrease in white blood cell count [P < 0.05 on postoperative day (POD) 3 and 4], alleviated pain in patients after surgery (P < 0.05 on POD 1, 2 and 3), reduced complications (P < 0.05), shortened the duration of postoperative stay (7.10 ± 2.13 dvs 5.68 ± 1.22 d,P = 0.000), reduced the cost of hospitalization (43783.25 ± 8102.36 RMBvs 39597.62 ± 7529.98 RMB,P = 0.005), and promoted recovery of patients. CONCLUSION: FTS could be safely applied in radical total gastrectomy to accelerate clinical recovery of gastric cancer patients.

Fast-track surgery在结直肠癌手术中的应用体会

目的:比较应用Fast-track surgery(快速通道外科,后简称FTS)治疗方案和传统方案治疗结直肠癌手术的效果。方法:对比114例结直肠癌手术患者,分别用加速康复外科和传统方案比较两组患者住院时间、费用、进食、活动时间、术后恢复情况和并发症等。结果:两组患者均痊愈。FTS组与对照组在各方面均有明显改善。结论:FTS治疗方案明显优于传统治疗。更有利于结直肠癌的外科治疗。

Pulmonary embolism after shoulder surgery:Is it a real threat?

Pulmonary embolism(PE)is a rare but devastating complication of shoulder surgery.Apart from increased morbidity and mortality rates,it may significantly impair postoperative recovery and functional outcome.Its frequency accounts for up to 5.7%of all shoulder surgery procedures with a higher occurrence in women and patients older than 70 years.It is most commonly associated with thrombophilia,diabetes mellitus,obesity,smoking,hypertension,and a history of malignancy.PE usually occurs secondary to upper or lower-extremity deep vein thrombosis(DVT).However,in rare cases,the source of the thrombi cannot be determined.Prophylaxis for PE following shoulder surgery remains a topic of debate,and the standard of care does not routinely require prophylactic medication for DVT prophylaxis.Early ambulation and elastic stockings are important preventative measures for DVT of the lower extremity and medical agents such as aspirin,low-molecular-weight heparin,and vitamin K antagonists are indicated for high-risk patients,long-lasting operations,or concomitant severe acute respiratory syndrome coronavirus 2 infection.The most common symptoms of PE include chest pain and shortness of breath,but PE can also be asymptomatic in patients with intrinsic tolerance of hypoxia.Patients with DVT may also present with swelling and pain of the respective extremity.The treatment of PE includes inpatient or outpatient anticoagulant therapy if the patient is hemodynamically unstable or stable,respectively.Hemodynamic instability may require transfer to the intensive care unit,and cardiovascular arrest can be implicated in fatal events.An important issue for patients with PE in the postoperative period after shoulder surgery is residual stiffness due to a delay in rehabilitation and a prolonged hospital stay.Early physiotherapy and range-of-motion exercises do not adversely affect the prognosis of PE and are highly recommended to preserve shoulder mobility and function.

Clinical Application of Fast-Track Surgery with Chinese Medicine Treatment in the Devascularization Operation for Cirrhotic Portal Hypertension

Objective： To investigate the clinical effect of fast-track surgery combined with Chinese medicine treatment in devascularization operation for cirrhotic esophageal varices. Methods： Seventy-two patients with cirrhotic esophageal varices were selected from January 2009 to June 2013, and randomly assigned to a conventional group and a fast-track group （fast-track surgery combined with Chinese medicine treatment） using a randomized digital table, 36 cases in each group. Operation and anesthesia recovery time, postoperative hospitalization and quality of life were recorded and compared between groups during the perioperative period. Results： Compared with the conventional group, the fast-track group had longer operation time （253.6±46.4 min vs. 220.6±51.0 min） and anesthesia recovery time （50.5 ± 15.9 rain vs. 23.5± 9.6 min; P〈0.01）; less bleeding （311.3±46.8 mL vs. 356.2 ± 57.5 mL; P〈0.01） and less transfusion （1932.3 ± 106.9 mL vs. 2045.6 ± 115.4 mL; P〈0.01）; as well as faster recovery of gastrointestinal function, shorter postoperative hospitalization and higher quality of life. There were no serious postoperative complications and no further bleeding occurred. Conclusion： Fast-track surgery combined with Chinese medicine treatment is a safe and feasible approach to accelerate the recovery of patients with cirrhotic portal hypertension in perioperative period of devascularization operation.

Fast-track program in laparoscopic liver surgery:Theory or fact?

AIM:To analyze our results after the introduction of a fast-track(FT) program after laparoscopic liver surgery in our Hepatobiliarypancreatic Unit.METHODS:All patients(43) undergoing laparoscopic liver surgery between March 2004 and March 2010 were included and divided into two consecutive groups:Control group(CG) from March 2004 until December 2006 with traditional perioperative cares(17 patients) and fast-track group(FTG) from January 2007 until March 2010 with FT program cares(26 patients).Primary endpoint was the influence of the program on the postoperative stay,the amount of re-admissions,morbidity and mortality.Secondarily we considered duration of surgery,use of drains,conversion to open surgery,intensive cares needs and transfusion.RESULTS:Both groups were homogeneous in age and sex.No differences in technique,time of surgery or conversion to open surgery were found,but more malignant diseases were operated in the FTG,and then transfusions were higher in FTG.Readmissions and morbidity were similar in both groups,without mortality.Postoperative stay was similar,with a median of 3 for CG vs 2.5 for FTG.However,the 80.8% of patients from FTG left the hospital within the first 3 d after surgery(58.8% for CG).CONCLUSION:The introduction of a FT program after laparoscopic liver surgery improves the recovery of patients without increasing complications or re-admissions,which leads to a reduction of the stay and costs.

Fast-track program vs traditional care in surgery for gastric cancer

AIM:To systematically review the evidence for the effectiveness of fast-track program vs traditional care in laparoscopic or open surgery for gastric cancer.METHODS:PubMed,Embase and the Cochrane library databases were electronically searched for published studies between January 1995 and April 2013,and only randomized trials were included.The references of relevant studies were manually searched for further studies that may have been missed.Search terms included"gastric cancer","fast track"and"enhanced recovery".Five outcome variables were considered most suitable for analysis:postoperative hospital stay,medical cost,duration to first flatus,C-reactive protein(CRP)level and complications.Postoperative hospital stay was calculated from the date of operation to the date of discharge.Fixed effects model was used for meta-analysis.RESULTS:Compared with traditional care,fasttrack program could significantly decrease the postoperative hospital stay[weighted mean difference(WMD)=-1.19,95%CI:-1.79--0.60,P=0.0001,fixed model],duration to first flatus(WMD=-6.82,95%CI:-11.51--2.13,P=0.004),medical costs(WMD=-2590,95%CI:-4054--1126,P=0.001),and the level of CRP(WMD=-17.78,95%CI:-32.22--3.35,P=0.0001)in laparoscopic surgery for gastric cancer.In open surgery for gastric cancer,fast-track program could also significantly decrease the postoperative hospital stay(WMD=-1.99,95%CI:-2.09--1.89,P=0.0001),duration to first flatus(WMD=-12.0,95%CI:-18.89--5.11,P=0.001),medical cost(WMD=-3674,95%CI:-5025--2323,P=0.0001),and the level of CRP(WMD=-27.34,95%CI:-35.42--19.26,P=0.0001).Furthermore,fast-track program did not significantly increase the incidence of complication(RR=1.39,95%CI:0.77-2.51,P=0.27,for laparoscopic surgery;and RR=1.52,95%CI:0.90-2.56,P=0.12,for open surgery).CONCLUSION:Our overall results suggested that compared with traditional care,fast-track program could result in shorter postoperative hospital stay,less medical costs,and lower level of CRP,with no more complications occurring in both laparoscopic and open surgery for gastric cancer.

Safety of fast-track rehabilitation after gastrointestinal surgery:Systematic review and meta-analysis

AIM: To compare the safety of fast-track rehabilitation protocols (FT) and conventional care strategies (CC), or FT and laparoscopic surgery (LFT) and FT and open surgery (OFT) after gastrointestinal surgery.

New direction for surgery:Super minimally invasive surgery

The top goal of modern medicine is treating disease without destroying organ structures and making patients as healthy as they were before their sickness.Minimally invasive surgery(MIS)has dominated the surgical realm because of its lesser invasiveness.However,changes in anatomical structures of the body and reconstruction of internal organs or different organs are common after traditional surgery or MIS,decreasing the quality of life of patients post-operation.Thus,I propose a new treatment mode,super MIS(SMIS),which is defined as“curing a disease or lesion which used to be treated by MIS while preserving the integrity of the organs”.In this study,I describe the origin,definition,operative channels,advantages,and future perspectives of SMIS.

Bariatric surgery and diabetes:Current challenges and perspectives

Diabetes mellitus(DM)and obesity have become public issues of global concern.Bariatric surgery for the treatment of obesity combined with type 2 DM has been shown to be a safe and effective approach;however,there are limited studies that have systematically addressed the challenges of surgical treatment of obesity combined with DM.In this review,we summarize and answer the most pressing questions in the field of surgical treatment of obesity-associated DM.I believe that our insights will be of great help to clinicians in their daily practice.

Fast-track protocols in laparoscopic liver surgery:Applicability and correlation with difficulty scoring systems

BACKGROUND Few series have reported the utility of fast-track protocols(FTP)in minimally invasive liver surgery.AIM To report the applicability of FTP in minimally invasive liver surgery and to correlate with difficulty scores.METHODS The series of patients undergoing minimally invasive liver surgery from 2014 was analyzed.Iwate,Southampton and Gayet’s scores were compared as predictors of FTP adherence.Accomplishment of FTP was considered within 24-h,48-h and 72-h.Multivariate models were performed to define discharge<24 h,<72 h,complications and readmissions.RESULTS From 160 cases,78 were candidates for FTP,of which 22(28.2%),19(24.4%)and 14(17.9%)were discharged in<24-h,48-h and 72-h,respectively(total=71.5%).Iwate,Southampton and Gayet’s scores achieved area under the receiver operating characteristic values for<24-h stay of 0.780,0.687 and 0.698,respectively.Sensitivity and specificity values for the best score(Iwate)were 87.7%and 66.7%,respectively(cutoff=5.5).In multivariate models,<72 h stay and complications revealed body mass index as a risk factor independent from difficulty scores.CONCLUSION The development of aggressive FTP is feasible and<24-h stay can be achieved even in moderate and advanced complexity cases.Difficulty scores,including body mass index value,may be useful to predict which cases may adhere to these protocols.

Artificial Intelligence and Computer Vision during Surgery: Discussing Laparoscopic Images with ChatGPT4—Preliminary Results

Introduction: Ultrafast latest developments in artificial intelligence (ΑΙ) have recently multiplied concerns regarding the future of robotic autonomy in surgery. However, the literature on the topic is still scarce. Aim: To test a novel AI commercially available tool for image analysis on a series of laparoscopic scenes. Methods: The research tools included OPENAI CHATGPT 4.0 with its corresponding image recognition plugin which was fed with a list of 100 laparoscopic selected snapshots from common surgical procedures. In order to score reliability of received responses from image-recognition bot, two corresponding scales were developed ranging from 0 - 5. The set of images was divided into two groups: unlabeled (Group A) and labeled (Group B), and according to the type of surgical procedure or image resolution. Results: AI was able to recognize correctly the context of surgical-related images in 97% of its reports. For the labeled surgical pictures, the image-processing bot scored 3.95/5 (79%), whilst for the unlabeled, it scored 2.905/5 (58.1%). Phases of the procedure were commented in detail, after all successful interpretations. With rates 4 - 5/5, the chatbot was able to talk in detail about the indications, contraindications, stages, instrumentation, complications and outcome rates of the operation discussed. Conclusion: Interaction between surgeon and chatbot appears to be an interesting frontend for further research by clinicians in parallel with evolution of its complex underlying infrastructure. In this early phase of using artificial intelligence for image recognition in surgery, no safe conclusions can be drawn by small cohorts with commercially available software. Further development of medically-oriented AI software and clinical world awareness are expected to bring fruitful information on the topic in the years to come.

Fully automatic AI segmentation of oral surgery-related tissues based on cone beam computed tomography images

Accurate segmentation of oral surgery-related tissues from cone beam computed tomography(CBCT)images can significantly accelerate treatment planning and improve surgical accuracy.In this paper,we propose a fully automated tissue segmentation system for dental implant surgery.Specifically,we propose an image preprocessing method based on data distribution histograms,which can adaptively process CBCT images with different parameters.Based on this,we use the bone segmentation network to obtain the segmentation results of alveolar bone,teeth,and maxillary sinus.We use the tooth and mandibular regions as the ROI regions of tooth segmentation and mandibular nerve tube segmentation to achieve the corresponding tasks.The tooth segmentation results can obtain the order information of the dentition.The corresponding experimental results show that our method can achieve higher segmentation accuracy and efficiency compared to existing methods.Its average Dice scores on the tooth,alveolar bone,maxillary sinus,and mandibular canal segmentation tasks were 96.5%,95.4%,93.6%,and 94.8%,respectively.These results demonstrate that it can accelerate the development of digital dentistry.

Is recovery enhancement after gastric cancer surgery really a safe approach for elderly patients?

BACKGROUND This study aimed to evaluate the safety of enhanced recovery after surgery(ERAS)in elderly patients with gastric cancer(GC).AIM To evaluate the safety of ERAS in elderly patients with GC.METHODS The PubMed,EMBASE,and Cochrane Library databases were used to search for eligible studies from inception to April 1,2023.The mean difference(MD),odds ratio(OR)and 95%confidence interval(95%CI)were pooled for analysis.The quality of the included studies was evaluated using the Newcastle-Ottawa Scale scores.We used Stata(V.16.0)software for data analysis.RESULTS This study consists of six studies involving 878 elderly patients.By analyzing the clinical outcomes,we found that the ERAS group had shorter postoperative hospital stays(MD=-0.51,I2=0.00%,95%CI=-0.72 to-0.30,P=0.00);earlier times to first flatus(defecation;MD=-0.30,I²=0.00%,95%CI=-0.55 to-0.06,P=0.02);less intestinal obstruction(OR=3.24,I2=0.00%,95%CI=1.07 to 9.78,P=0.04);less nausea and vomiting(OR=4.07,I2=0.00%,95%CI=1.29 to 12.84,P=0.02);and less gastric retention(OR=5.69,I2=2.46%,95%CI=2.00 to 16.20,P=0.00).Our results showed that the conventional group had a greater mortality rate than the ERAS group(OR=0.24,I2=0.00%,95%CI=0.07 to 0.84,P=0.03).However,there was no statistically significant difference in major complications between the ERAS group and the conventional group(OR=0.67,I2=0.00%,95%CI=0.38 to 1.18,P=0.16).CONCLUSION Compared to those with conventional recovery,elderly GC patients who received the ERAS protocol after surgery had a lower risk of mortality.

Enhanced recovery after surgery in elderly patients with non-small cell lung cancer who underwent video-assisted thoracic surgery

BACKGROUND This study was designed to investigate the clinical outcomes of enhanced recovery after surgery(ERAS)in the perioperative period in elderly patients with nonsmall cell lung cancer(NSCLC).AIM To investigate the potential enhancement of video-assisted thoracic surgery(VATS)in postoperative recovery in elderly patients with NSCLC.METHODS We retrospectively analysed the clinical data of 85 elderly NSCLC patients who underwent ERAS(the ERAS group)and 327 elderly NSCLC patients who received routine care(the control group)after VATS at the Department of Thoracic Surgery of Peking University Shenzhen Hospital between May 2015 and April 2017.After propensity score matching of baseline data,we analysed the postoperative stay,total hospital expenses,postoperative 48-h pain score,and postoperative complication rate for the 2 groups of patients who underwent lobectomy or sublobar resection.RESULTS After propensity score matching,ERAS significantly reduced the postoperative hospital stay(6.96±4.16 vs 8.48±4.18 d,P=0.001)and total hospital expenses(48875.27±18437.5 vs 55497.64±21168.63 CNY,P=0.014)and improved the satisfaction score(79.8±7.55 vs 77.35±7.72,P=0.029)relative to those for routine care.No significant between-group difference was observed in postoperative 48-h pain score(4.68±1.69 vs 5.28±2.1,P=0.090)or postoperative complication rate(21.2%vs 27.1%,P=0.371).Subgroup analysis showed that ERAS significantly reduced the postoperative hospital stay and total hospital expenses and increased the satisfaction score of patients who underwent lobectomy but not of patients who underwent sublobar resection.CONCLUSION ERAS effectively reduced the postoperative hospital stay and total hospital expenses and improved the satisfaction score in the perioperative period for elderly NSCLC patients who underwent lobectomy but not for patients who underwent sublobar resection.