Observation of the Effectiveness of Rapid Recovery Nursing on Lung Cancer Surgery Patients and Its Impact on Sleep Quality

Objective: To investigate the nursing effects of rapid recovery care measures on lung cancer surgery patients. Methods: 42 cases of lung cancer surgery patients were divided into control group and study group, with 21 cases in each group. The sleep quality and postoperative recovery indicators were compared between the two groups. Results: The study group showed better results than the control group in terms of PSQI scores, venting time, extubation time, time to getting out of bed, and duration of antibiotic use, with P Conclusion: Rapid recovery nursing has a positive impact on improving sleep quality and promoting postoperative recovery in lung cancer surgery patients.

Clinical Practice of Evidence-Based PDCA Cycle Management Model in Accelerated Recovery of Lung Cancer Patients

Objective: To explore the nursing effect of evidence-based PDCA cycle management mode in accelerated rehabilitation of patients undergoing thoracoscopic lung cancer radical surgery. Methods: 104 patients who underwent thoracoscopic lung cancer radical surgery in our hospital from June 2022 to February 2023 were randomly divided into control group and intervention group, with 52 cases in each group. The control group implemented evidence-based ERAS clinical pathway management, while the intervention group implemented evidence-based PDCA cycle quality management. The postoperative recovery of the two groups of patients was compared. Results: The postoperative recovery of the intervention group was significantly better than that of the control group. The first time to get out of bed, the first time to eat, the duration of chest drainage tube placement, and the length of hospital stay were significantly shorter than those of the control group. The incidence of postoperative chest complications and hospitalization costs were significantly lower than those of the control group, and patient satisfaction was significantly higher than that of the control group (P Conclusion: Evidence-based PDCA cycle quality management mode can effectively improve the implementation quality of accelerated rehabilitation nursing for patients undergoing thoracoscopic lung cancer radical surgery, and it is worthy of clinical promotion.

A lobe-specific lymphadenectomy protocol for solitary pulmonary nodules in non-small cell lung cancer

Background： We want to establish a lobe-specific mediastinal lymphadenectomy protocol for solitary pulmonary nodules （SPNs） in non-small cell lung cancer （NSCLC）. Methods： We retrospectively analyzed 401 patients with pathological diagnoses of NSCLC who underwent lobectomy, bilobectomy, or pneumonectomy with systematic lymphadenectomy from March 2004 to June 2011 in our hospital. All of the patients enrolled had a SPN preoperatively. Information about the primary tumor location, lymph node metastasis, and other baseline data were collected. Stepwise logistic regression was used to identify the key factors indicating non-regional mediastinal lymph node metastases （NRM）. Results： Of the primary tumors, 117, 39, 74, 104, and 67 were in the right upper lung （RUL）, right middle lung （RML）, right lower lung （RLL）, left upper lung （LUL）, and left lower lung （LLL）, respectively. Stepwise regression showed that #2,4, #10,11, and #10,11 as well as #7 was the key lymph node station for RUL, LUL, and lower lobes： #2,4 [odds ratio （OR）=28.000, 95% confidence interval （CI）： 2.917-268.790, P=0.004] for RUL, #10,11 （OR=31.667, 95% CI： 2.502-400.833, P=0.008） for LUL, #10,11 （OR=19.540, 95% CI： 4.217-90.541, P〈0.001） and #7 （OR=7.395, 95% CI： 1.586-34.484, P=0.011） for lower lobes, respectively. Patients with tumors 〉2 cm rarely had NRM without primary regional mediastinal involvement. Conclusions： With rigid consideration, a lobe-specific lymphadenectomy is feasible in practice. This protocol can be used when the lobe-specific key nodes are negative in intraoperative frozen sections, especially for NSCLC diagnosed as SPN 〈2 cm preoperatively.

Application of Intensive Pain Nursing in Postoperative Nursing of Clinical Patients with Lung Cancer

Objective:The intensive pain nursing was added to the surgical nursing of lung cancer and the clinical nursing effect was discussed.Methods:50 patients with lung cancer received in our hospital from January 2020 to June 2021.The observation group was given intensive pain nursing and the control group was given routine nursing.The clinical nursing effects of the two groups were studied.Results:The pain degree of the two groups was improved after nursing.The pain relief effect of the observation group was higher than that of the control group,and the nursing effect of the two groups was different(P<0.05)・Conclusion:In the postoperative nursing of patients with lung cancer,the intervention of intensive pain nursing can relieve the pain of patients,which is worth popularizing.

Surgical Treatment of Lung Cancer in Patients with Psychiatric Disorders: A Retrospective Study

Background: The purpose of this retrospective study was to examine the clinical outcomes of patients with concomitant lung cancer and psychiatric disorders who underwent pulmonary resection at our institution and develop a strategy for treating such patients in the future. Methods: We retrospectively reviewed 23 patients with psychiatric disorders who underwent pulmonary resection for lung cancer at our institution between January 1984 and December 2011. Results: The study population comprised 13 men and 10 women with an average age of 67.4 years. The histological types of lung cancer included adenocarcinoma in 14 patients, squamous cell carcinoma in 4, and other types in 5. Fifteen patients were classified as having pathological TNM stage I cancer, four as having stage II, three as having stage III, and one as having stage IV. The coexisting psychiatric disorders were neurosis in eight patients, depression in seven, schizophrenia in five, dementia in two, and oligophrenia in one. Three patients were admitted without a full understanding of the operation. There were no major complications with the exception of delirium, which was seen in eight patients. None of these patients’ coexisting psychiatric disorders worsened. No perioperative death occurred. Conclusions: At our institution, we cooperate closely with psychiatrists to care for surgical patients with psychiatric disorders. There is a possibility that such cooperation will reduce the frequency of previously reported complications.

Adjuvant chemotherapy following radical surgery for non-small-cell lung cancer: a randomized study on 70 patients

To evaluate the efficacy of adjuvantchemotherapy after radical surgery for non-small-celllung cancer (NSCLC). Methods Seventy patients with NSCLC (stages Ⅰ -Ⅲ ) undergoing radical surgery were randomized intotwo groups. Group 1 (n = 35): combination group,which received adjuvant chemotherapy withcyclophosphamide 300 mg/m 2, vincristine 1. 4 mg/m 2,adriamycin 50 mg/m 2, and lomustine 50 mg/m 2 on day1, and cisplatin 20 mg/m 2 on days 1-5. Thetreatment was repeated every 4-6 weeks for 4 cycles,followed by oral administration of ftorafur (FT-207) 600-900 mg/d for 1 year. Group 2 (n = 35): surgerygroup, which received surgical treatment only. Results The overall 5-year survival rate was 48.6%in the combination group versus 31 .4% in the surgerygroup, and difference between the two groups was notStatistically significant (x 2 = 3.09, P > 0.05). The year survival rate for patients with stage Ⅲ diseasewas 44% and 20.8% in the combination and surgerygroups, respectively, showing a statistically significantdifference (x 2 = 5.28, P < 0.025). The 5-yearsurvival rates of patients in stages Ⅰ -Ⅱ in the twogroups were 60.0% and 54.5%, respectively, andwere not significantly different (x 2 = 0. 03, P > 0. 75). Conclusion Postoperative adjuvant chemotherapy provides statistically significant improvement in the 5 year survival rate only in patients with stage ⅢNSCLC.

VATS Right Upper Lobe Anterior Segmentectomy in Post Left Pneumonectomy: Technique

Lung resection following pneumonectomy for recurrent lung cancer is a challenging scenario.Peri-operative airway management and choice of surgical procedure are issues to be addressed by both the anesthesiologists and thoracic surgeons.We hereby report a case of anterior segmentectomy of the right upper for recurrent lung cancer,in a patient who had previously underwent pneumonectomy for primary lung cancer one year earlier.A modified conventional tracheal intubation and unique surgical techniques were applied for video-assisted thoracoscopic surgery(VATS)anterior segmentectomy of the right upper lobe in a patient with a notable mediastinal shift(following contralateral pneumonectomy),resulting in a good recovery and clinical outcome.The clinical experience is summarized in detail in this article.