Anatomic Lung Resection Outcomes After Implementation of a Universal Thoracic ERAS Protocol Across a Diverse Health Care System.

Objective: We sought to evaluate how implementing a thoracic enhanced recovery after surgery (ERAS) protocol impacted surgical outcomes after elective anatomic lung resection.

Background: The effect of implementing the ERAS Society/European Society of Thoracic Surgery thoracic ERAS protocol on postoperative outcomes throughout an entire health care system has not yet been reported.

Methods: This was a prospective cohort study within one health care system (January 2019-March, 2023).

Development of a universal thoracic enhanced recover after surgery protocol for implementation across a diverse multi-hospital health system.

Background: Implementation of enhanced recovery after surgery (ERAS) pathways for patients undergoing anatomic lung resection have been reported at individual institutions. We hypothesized that an ERAS pathway can be successfully implemented across a large healthcare system including different types of hospital settings (academic, academic-affiliated, community).

Methods: An expert panel with representation from each hospital within a healthcare system was convened to establish a thoracic ERAS pathway for patients undergoing anatomic lung resection and to develop tools and analytics to ensure consistent application.

Minimally Invasive and Open Approaches to Mediastinal Nodal Assessment.

There is no consensus on mediastinal lymph node dissection versus sampling for early-stage lung cancer. There are also mixed data on the ability to remove an adequate number of lymph nodes by a minimally invasive approach. In this review, we discuss the difference between dissection and sampling, what circumstances dictate the use of one or the other during an anatomic pulmonary resection for lung cancer, and when it is appropriate to use minimally invasive versus open approaches in the assessment of mediastinal nodes.