Abstract:

Objective To evaluate the effect of single utility port video-assisted thoracoscopic surgery (SP-VATS) combined with enhanced recovery after surgery (ERAS) in the treatment of tuberculous empyema. Methods Clinical data of 113 tuberculous pustular chest patients admitted to Tuberculosis Hospital of Shaanxi Province from December 2017 to December 2020 were retrospectively studied. Fifty-four patients who underwent SP-VATS only from December 2017 to December 2019 were selected as the SP-VATS group, and 59 patients who underwent SP-VATS and perioperative ERAS from January 2020 to December 2020 were selected as the SP-VATS+ERAS group, the time to leave bed, recovery time of bowel sounds, hospital stay, extubation time, postoperative pain and surgical complications in the two groups were compared. Results The time to leave bed, recovery time of bowel sounds, hospital stay, extubation time, incidence rate of complications, pain scores 1, 12 and 24 h after operation in the SP-VATS+ERAS group were significantly shorter or lower than those in the SP-VATS group (10 (8,13) h vs. 13 (10,17) h, Z=3.777, P=0.000; (18.25±3.52) h vs. (20.35±3.45) h, t=3.198, P=0.002; (17.75±3.68) d vs. (19.45±3.56) d, t=2.491, P=0.014; 6 (5, 7) d vs. 7(5, 9) d, Z=3.342, P=0.001; 20.34% (12/59) vs. 38.89% (21/54), χ²=4.690, P=0.030; 3.26±1.32 vs. 5.58±1.68, t=8.198,P=0.000; 5.59±1.54 vs. 6.35±1.57, t=2.596,P=0.011; 4.0 (3.5,5.0) vs. 5.5(4.0,7.0), Z=3.191, P=0.001). Conclusion Compared to the SP-VATS treated with the SP-VATS combined with the ERAS,the tuberculous empyema patients will recover faster, suffer less pain and fewer postoperative complications,and the hospitalization stay is shorter. The SP-VATS combined with the ERAS is safe and effective in the tuberculosis surgery.

Key words: Empyema, tuberculosis, Enhanced recovery after surgery, Thoracoscopy, Comparative study