V-110
EXTREME FAST-TRACK REHABILITATION IN THORACIC SURGERY: INTERNATIONAL BICENTRIC PROSPECTIVE STUDY

Objectives: To verify if it is possible and safe to perform outpatient or overnight general thoracic surgery, including lobectomy, applying the ‘Fast-Track’ rehabilitation programme. This prospective study was carried out in two departments of General Thoracic Surgery in University Hospitals.

Video description: Extreme Fast-Track rehabilitation protocol was applied in two General Thoracic Surgery Departments in two countries. Major surgical procedures, except pneumonectomy and pleuropneumonectomy, were included. It consisted in immediate postoperative extubation followed by massage and physiotherapy in the recovery room. Within the first 4 hours oral feeding and intense physical exercises were performed as soon as possible under oral opioid-free analgesia. Elder patients walked and biked according to their specific capabilities, younger patients could even run at the nursery corridor without pain. Physiotherapists also teached patients families how to perform quick massage at home in order to obtain muscle relaxation. Some patients who underwent both traditional and extreme Fast-Track rehabilitation protocol for General Thoracic surgeries describe their comparative experience. Even lung transplanted patient received Fast-Track rehabilitation care. Finally it shows a patient running in an outside garden some minutes after extubation of a wedge resection thoracic surgery.

Conclusions: Outpatient and overnight thoracic surgery is possible and safe, thanks to the extreme ‘Fast-Track’ rehabilitation programme but a motivated interdisciplinary group is required to carry it out routinely.

Disclosure: No significant relationships.