Skip to main content
SpringerLink
Log in

Preoperative respiratory intervention eliminated the operation cancelations of lobectomy surgery

  • Implementation Science & Operations Management
  • Published:
Journal of Medical Systems Aims and scope Submit manuscript

Abstract

In Nagasaki University Hospital, the patients undergoing surgery with abnormal respiratory function have been automatically referred to specialized clinic by Medical Support Center (MSC) since July 2016 to reduce surgery cancellations due to insufficient preoperative evaluation. Whether the MSC system decreased post-hospital surgery cancellation, variance rate, or length of hospital stays in patients received “lobectomy” were retrospectively compared between Period A (n = 264, before MSC introduction) and Period B (n = 264, after MSC introduction). Four patients’ operations were cancelled after hospitalization in Period A, while 0 patients in Period B (p < 0.05). The length of hospital stay, operation time, anesthesia time, and postoperative extubation oxygen administration time were all shorten in Period B significantly. “Period B”, “operation time”, and “postoperation oxygenation time” were independent factors for “hospital days”, but chronic obstructive pulmonary disease or age were not. The preoperative intervention eliminated the operation cancellation. Preoperative MSC interventions may have contributed to the reduction in hospital days even for the patients with pulmonary dysfunction.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Imperatori A, Rotolo N, Gatti M, Nardecchia E, De Monte L, Conti V, et al. (2008) Peri-operative complications of video-assisted thoracoscopic surgery (VATS). Int J Surg.; 6 Suppl 1:S78-81.

    PubMed  Google Scholar 

  2. Solaini L, Prusciano F, Bagioni P, di Francesco F, Solaini L, Poddie DB. (2008) Video-assisted thoracic surgery (VATS) of the lung: analysis of intraoperative and postoperative complications over 15 years and review of the literature. Surg Endosc.22:298–310.

    Article  CAS  Google Scholar 

  3. Smetana GW, Lawrence VA, Cornell JE. (2006) Preoperative pulmonary risk stratification for noncardiothoracic surgery: systematic review for the American College of Physicians. American College of Physicians. Ann Intern Med. 144:581–95.

    Article  Google Scholar 

  4. Mills GH (2018) Respiratory complications of anaesthesia. Anaesthesia.73:25–33.

    Article  Google Scholar 

  5. Miskovic A, Lumb AB. (2017) Postoperative pulmonary complications. British Journal of Anaesthesia. 118:317–34.

    Article  CAS  Google Scholar 

  6. Lumb AB (2019) Pre-operative respiratory optimization: an expert review. Anaesthesia. 74:43–48.

    Article  Google Scholar 

  7. Licker M, Schweizer A, Ellenberger C, Tschopp JM, Diaper J, Clergue F. (2007) Perioperative medical management of patients with COPD. Int J Chron Obstruct Pulmon Dis.2:493–515.

    PubMed  PubMed Central  Google Scholar 

  8. Wong SL, Revels SL, Yin H, Stewart AK, McVeigh A, Banerjee M, et al. (2015) Variation in hospital mortality rates with inpatient cancer surgery. Ann Surg. 261:632–6.

    Article  Google Scholar 

  9. Martin LW, Sarosiek BM, Harrison MA, Hedrick T, Isbell JM, Krupnick AS, et al. (2018) Implementing a Thoracic Enhanced Recovery Program: Lessons Learned in the First Year. Ann Thorac Surg. 105:1597–1604.

    Article  Google Scholar 

  10. Kaplan EB, Sheiner LB, Boeckmann AJ, Roizen MF, Beal SL, Cohen SN, et al. (1985) The usefulness of preoperative laboratory screening. JAMA. 253:3576–81.

    Article  CAS  Google Scholar 

  11. Roizen MF (2000) More preoperative assessment by physicians and less by lab tests. N Engl J Med. 342:204–5.

    Article  CAS  Google Scholar 

  12. Gjeraa K, Dieckmann P, Spanager L, Petersen RH, Østergaard D, Park YS, et al. (2019) Exploring Shared Mental Models of Surgical Teams in Video-Assisted Thoracoscopic Surgery Lobectomy. Ann Thorac Surg. 107:954–961.

    Article  Google Scholar 

  13. Wijeysundera DN, Austin PC, Beattie WS, Hux JE, Laupacis A (2012) Variation in the practice of preoperative medical consultation for major elective noncardiac surgery: a population-based study. Anesthesiology. 116:25–34.

    Article  Google Scholar 

  14. Lakshminarasimhachar A, Smetana GW (2016) Preoperative Evaluation: Estimation of Pulmonary Risk. Anesthesiol Clin. 34:71–88.

    Article  Google Scholar 

  15. Zhang R, Kyriss T, Dippon J, Ciupa S, Boedeker E, Friedel G (2018) Impact of comorbidity burden on morbidity following thoracoscopic lobectomy: a propensity-matched analysis. Thorac Dis. 10:1806–1814.

    Article  Google Scholar 

  16. Davenport DL, Henderson WG, Khuri SF, Mentzer RM Jr (2005) Preoperative risk factors and surgical complexity are more predictive of costs than postoperative complications: a case study using the National Surgical Quality Improvement Program (NSQIP) database. Ann Surg. 242:463–71.

    Article  Google Scholar 

  17. Fischer SP (1996) Development and effectiveness of an anesthesia preoperative evaluation clinic in a teaching hospital. Anesthesiology. 85:196–206.

    Article  CAS  Google Scholar 

  18. Mazo V, Sabaté S, Canet J, Gallart L, de Abreu MG, Belda J, et al. (2014) Prospective external validation of a predictive score for postoperative pulmonary complications. Anesthesiology. 121:219–31.

    Article  Google Scholar 

  19. Silvanus MT, Groeben H, Peters J (2004) Corticosteroids and inhaled salbutamol in patients with reversible airway obstruction markedly decrease the incidence of bronchospasm after tracheal intubation. Anesthesiology.100:1052–7.

    Article  CAS  Google Scholar 

  20. Bapoje SR, Whitaker JF, Schulz T, Chu ES, Albert RK (2007) Preoperative evaluation of the patient with pulmonary disease. Chest. 132:1637–45.

    Article  Google Scholar 

  21. Groth SS, Whitson BA, Kuskowski MA, Holmstrom AM, Rubins JB, Kelly RF (2009) Impact of preoperative smoking status on postoperative complication rates and pulmonary function test results 1-year following pulmonary resection for non-small cell lung cancer. Lung Cancer. 64:352–7.

    Article  Google Scholar 

  22. Ramakrishna G, Sprung J, Ravi BS, Chandrasekaran K, McGoon MD (2005) Impact of pulmonary hypertension on the outcomes of noncardiac surgery: predictors of perioperative morbidity and mortality. J Am Coll Cardiol.45:1691–9.

    Article  Google Scholar 

  23. Park JB, Lee SA, Lee WS, Kim YH, Song I, Lee JG, et al. (2019) Computed tomography-guided percutaneous hook wire localization of pulmonary nodular lesions before video-assisted thoracoscopic surgery: Highlighting technical aspects. Ann Thorac Med. 14:205–212.

    Article  Google Scholar 

  24. Izumo T, Terada Y, Inomata M, Kuse N, Awano N, Tone M, et al. (2019) Impact of preoperative pathological confirmation on surgical and postoperative outcomes of lung resection for early stage lung cancer. Adv Respir Med. 87:203–208.

    Article  Google Scholar 

  25. Dronkers J, Veldman A, Hoberg E, van der Waal C, van Meeteren N (2008) Prevention of pulmonary complications after upper abdominal surgery by preoperative intensive inspiratory muscle training: a randomized controlled pilot study. Clin Rehabil. 22:134–42.

    Article  Google Scholar 

  26. Cavalheri V, Granger C (2017) Preoperative exercise training for patients with non-small cell lung cancer. Cochrane Database Syst Rev. 7:6.

    Google Scholar 

  27. Steffens D, Beckenkamp PR, Hancock M, Solomon M, Young J (2018) Preoperative exercise halves the postoperative complication rate in patients with lung cancer: a systematic review of the effect of exercise on complications, length of stay and quality of life in patients with cancer. Br J Sports Med. 52:344.

    Article  Google Scholar 

  28. Sanchez-Lorente D, Navarro-Ripoll R, Guzman R, Moises J, Gimeno E, Boada M, et al (2018) Prehabilitation in thoracic surgery. J Thorac Dis. 10:S2593-S2600.

    Article  Google Scholar 

Download references

Acknowledgements

The authors thank all the subjected patients. The authors thank to Mayumi Yamamura, Midori Watarizaki, Aiko Takamura, Tomo Morizaki, Marie Takeda, and Maria Urakawa as MSC nurses, Takuya Ushijima for collecting the data from electronic medical records system, and Hiroaki Aihara for his assistance as data management.

Funding

No funding.

Author information

Authors and Affiliations

  1. Nagasaki University School of Medicine, Sakamoto 1-7-1, 852-8102, Nagasaki, Japan

    Eriho Yamaguchi

  2. Department of Respiratory Medicine, Nagasaki University Hospital, Sakamoto 1-7-1, 852-8102, Nagasaki, Japan

    Yasushi Obase M.D., Ph.D., Susumu Fukahori M.D., Ph.D., Jun Iriki M.D., Noriho Sakamoto M.D., Ph.D., Chizu Fukushima M.D., Ph.D. & Hiroshi Mukae M.D., Ph.D.

  3. Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Sakamoto 1-7- 1, 852-8102, Nagasaki, Japan

    Yasushi Obase M.D., Ph.D., Noriho Sakamoto M.D., Ph.D. & Hiroshi Mukae M.D., Ph.D.

  4. Center of Health and Community Medicine, Nagasaki University, Bunkyo 1-14, 852-8521, Nagasaki, Japan

    Tetsuya Kawano M.D., Ph.D.

  5. Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences, Sakamoto 1-7-1, 852-8102, Nagasaki, Japan

    Ryoichiro Doi M.D., Ph.D., Keitaro Matsumoto M.D., Ph.D., Tomoshi Tsuchiya M.D., Ph.D. & Takeshi Nagayasu M.D., Ph.D.

  6. Clinical Research Center, Nagasaki University Hospital, Sakamoto 1-7-1, 852-8102, Nagasaki, Japan

    Chizu Fukushima M.D., Ph.D.

  7. Medical Support Center, Nagasaki University Hospital, Sakamoto 1-7-1, 852-8102, Nagasaki, Japan

    Takehiro Matsumoto M.D., Ph.D.

Authors
  1. Eriho Yamaguchi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yasushi Obase M.D., Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Susumu Fukahori M.D., Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jun Iriki M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Tetsuya Kawano M.D., Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Noriho Sakamoto M.D., Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Ryoichiro Doi M.D., Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Keitaro Matsumoto M.D., Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Tomoshi Tsuchiya M.D., Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Chizu Fukushima M.D., Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Takehiro Matsumoto M.D., Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Takeshi Nagayasu M.D., Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Hiroshi Mukae M.D., Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Yasushi Obase M.D., Ph.D..

Ethics declarations

Conflict of interest

There are no conflicts of interests for any of the authors.

CRediT roles

Eriho Yamaguchi: Writing- Original draft preparation. Yasushi Obase: Conceptualization, Methodology, Writing- Reviewing and Editing. Susumu Fukahori: Methodology. Jun Iriki: Validation. Tetsuya Kawano: Data curation. Noriho Sakamoto: Methodology. Ryoichiro Doi: Conceptualization, Data curation. Keitaro Matsumoto: Data curation. Tomoshi Tsuchiya: Data curation. Chizu Fukushima: Data curation, Formal analysis. Takehiro Matsumoto: Supervision. Takeshi Nagayasu: Supervision. Hiroshi Mukae: Supervision.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Yamaguchi, E., Obase, Y., Fukahori, S. et al. Preoperative respiratory intervention eliminated the operation cancelations of lobectomy surgery. J Med Syst 46, 29 (2022). https://doi.org/10.1007/s10916-022-01811-5

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s10916-022-01811-5

Keywords

Search

Navigation