Impact of Perioperative Factors on Short-Term Patient Outcomes: Key Insights for Enhanced Surgical Success

Introduction

Lung cancer is mainly classified into small cell lung cancer and non-small cell lung cancer (NSCLC). NSCLC makes up about 85% of lung cancer cases. Surgery is the best treatment for early-stage NSCLC patients, regardless of age. However, elderly patients often face challenges due to reduced physiological function and existing health conditions, which can lead to high postoperative complications. This study focuses on the impact of perioperative management on short-term outcomes for elderly NSCLC patients. It aims to identify factors that affect recovery and improve management strategies.

Methods

Patients

The study involved patients over 60 years who underwent lung resection surgery.

Surgery and Anesthesia

Surgery was performed under general anesthesia with double-lumen endotracheal intubation. Anesthesia was induced with intravenous drugs and maintained with inhalational anesthetics. Different surgical techniques were used depending on the patient’s condition.

Data Collection

All data were collected from patients until discharge. The main focus was on postoperative complications, while the secondary focus was on the length of the hospital stay.

Statistical Analysis

Data were analyzed using various statistical tests. Continuous variables were compared using t-tests or Mann–Whitney tests, and categorical data were analyzed with chi-squared or Fisher’s exact tests.

Results

Over seven years, 490 patients were included after excluding 12 due to other conditions or missing data. Of these, 344 patients (70.2%) experienced postoperative complications, and the average hospital stay was 14 days. No patients died during the hospital stay.

Analysis of Postoperative Complications

Several factors were associated with increased complications. High levels of perioperative fentanyl and longer surgery times raised the risk.

Hospital Stay Analysis

Increased blood loss during surgery was linked to longer hospital stays of 14 days or more.

Discussion

This study highlights a high complication rate among elderly patients undergoing lung cancer surgery. Factors like opioid use and prolonged surgery time negatively influenced recovery. A potential link exists between opioid use and immune function impairment, which could exacerbate complications like pneumonia. Future studies are needed to explore these relationships further.

Limitations

The study’s limitations include its retrospective nature and small sample size. Findings should be confirmed with larger, multi-center studies.

Conclusion

Increased opioid use, longer surgical duration, and blood loss significantly impact recovery in elderly NSCLC patients. Optimizing perioperative strategies could improve outcomes and reduce hospital stays.