title: [Cross-sectoral Approach of a Perioperative Management Center for General Thoracic Surgery].
abstract: Perioperative assessment and care, such as enhanced recovery after surgery (ERAS), is very important for improving the clinical outcomes of patients who have undergone surgery. However, professional assessments and care cannot be achieved through the actions of only 1 surgical department. We established a perioperative management center(PERIO) comprised of surgeons, dedicated nurses, anesthesiologists, dentists, physiotherapists, pharmacists, and nutritionists to perform intensive cross-sectoral perioperative management. In this manuscript, we investigated the impact of PERIO on the clinical outcomes of 127 elderly patients who underwent thoracic surgery for the resection of non-small cell lung cancer (NSCLC). We categorized these 127 patients into 3 groups:① those treated before the introduction of PERIO (between January 2006 to August 2008), ② those treated during the early phase after PERIO introduction (September 2008 to December 2011), and ③ those treated during the late phase after PERIO introduction( January 2012 to December 2014). Radical operations were performed significantly more frequently after PERIO introduction than before PERIO introduction, while the postoperative complication rates were similar among the 3 groups. The duration of postoperative hospitalization was reduced after the introduction of PERIO, and the hospital surplus increased after the introduction of PERIO. In conclusion, PERIO may play an important role in improving the clinical outcomes of thoracic surgery, especially for elderly patients with NSCLC.
authors.affiliation: Department of General Thoracic Surgery, Breast and Endocrinological Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Science, Okayama University, Okayama, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Shimoda
authors.forename: Junichi
authors.initials: J
authors.lastname: Soh
authors.forename: Takako
authors.initials: T
authors.lastname: Ashiba
authors.forename: Naomichi
authors.initials: N
authors.lastname: Murata
authors.forename: Tomomi
authors.initials: T
authors.lastname: Fukuda
authors.forename: Motomu
authors.initials: M
authors.lastname: Kobayashi
authors.forename: Hidejiro
authors.initials: H
authors.lastname: Torigoe
authors.forename: Yuho
authors.initials: Y
authors.lastname: Maki
authors.forename: Seiichiro
authors.initials: S
authors.lastname: Sugimoto
authors.forename: Masaomi
authors.initials: M
authors.lastname: Yamane
authors.forename: Shinichi
authors.initials: S
authors.lastname: Toyooka
authors.forename: Takahiro
authors.initials: T
authors.lastname: Oto
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Miyoshi
mesh_terms: D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000601:surgery; D008297:Male; D010348:Patient Care Team; D059035:Perioperative Period; D011183:Postoperative Complications; D019616:Thoracic Surgical Procedures