Enhanced recovery pathway for thoracic surgery in the UK

Marco Scarci, Piergiorgio Solli, Benedetta Bedetti

Research output: Contribution to journalArticlepeer-review


Background: Enhanced recovery (ER) refers to a combination of perioperative interventions designed to minimise the impact of surgery on patients' recovery in order to reduce postoperative complications and to allow an early discharge reducing hospital costs. Methods: An ER protocol was established at our institution following a review of the best evidence available. We introduced a multi-disciplinary integrated perioperative pathway by engaging with every person involved, including the patients themselves. The programme was monitored using specificallydesigned patients related outcome measures (PROMs). Results: One-hundred and fifty-four ER patients were compared with 171 controls from the year before ER was introduced. There was an 80% increase in same-day admissions, with a net gain of more than 300 patient bed-days. The ER group had a significantly higher number of procedures performed by video assisted thoracoscopic surgery (VATS) (ER, 32.9% vs. 9.4%, P=0.0001) and a lower rate of admission to the intensive care unit (ER, 5.8% versus 12.9%, P=0.04). Patients on the ER programme had a significantly reduced postoperative length of stay (mean ER, 5.2 vs. 11.7 days, P

Original languageEnglish
Pages (from-to)S78-S83
JournalJournal of Thoracic Disease
Publication statusPublished - 2016


  • Enhanced recovery (ER)
  • Thoracic surgery

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine


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