An enhanced recovery after surgery program for video-assisted thoracoscopic surgery anatomical lung resections is cost-effective

Despite the various progresses observed in the field of chest surgery performed for malignancies in recent years, anatomical lung resections combined with a mediastinal lymph node dissection remain an invasive and traumatic procedure especially in elderly and friable patients affected by lung cancer. Although video-assisted thoracoscopic surgery (VATS) is now the preferred approach for early stage lung cancer, this type of surgery still induces important side effects and surgical stress and is associated with considerable postoperative, mainly cardio-pulmonary morbidity. Moreover, VATS anatomical resections are well-standardized procedures with respect to anesthesia and surgery as well as the postoperative management including chest drainage and analgesia. We hypothesized that an enhanced recovery after surgery (ERAS) program could help to reduce undesirable side effects related to lung cancer surgery leading to a shorter hospital stay and reduced treatment costs. Reports dealing with ERAS programs in thoracic surgery are relatively sparse in the literature (1)