Analysis of the multidisciplinary team in the surgical treatment of lung cancer by video-assisted thoracoscopic surgery_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

WANG Pengfei ^1,2 , DAI Weina ¹ , LIU Lixin ² , YUE Peng ² ,  HAN Biao ²

1. First Clinical Medical College, Lanzhou University, Lanzhou, 730030, P.R.China;
2. Thoracic Surgery Department, Lanzhou University First Hospital, Lanzhou, 730030, P.R.China;

Corresponding author：

HAN Biao, Email: hanbiao66@163.com

Keywords：

Multidisciplinary team; lung cancer; thoracoscope; complications; clinical efficacy

DOI：

10.7507/1007-4848.201903042

Video：

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Objective To investigate the effect of multidisciplinary team (MDT) on perioperative complications and clinical efficacy of patients who were receiver radical operation to treat lung cancer by video-assisted thoracoscopic surgery (VATS). Methods Eighty patients in the Thoracic Surgery Department of First Hospital of Lanzhou University from December 2017 to February 2019 who were diagnosed lung cancer were divided into two groups. Forty patients in the MDT group were treated with MDT discussion. The control group consisted of 40 patients who were treated without MDT discussion. The incidence of postoperative complications and clinical efficacy were compared between the two groups . Results There was no statistical difference in incision infection, atelectasis, pleural effusion and pulmonary leakage between the two groups. However, the incidence of postoperative pulmonary infection (5% vs. 20%, P=0.043) and the overall postoperative complications (17.5% vs. 42.5%, P=0.015) in the MDT group was lower than that in the control group with a statistical difference. In the MDT group, the operative time (140.3±8.0 min vs. 148.8±6.8 min, P<0.001), intraoperative bleeding ( 207.8±19.4 mL vs. 222.0±28.3 mL, P=0.010), lymph node dissection number (25.1±6.2 vs. 20.1±7.0, P=0.001), postoperative drainage (273.0±33.5 mL vs. 24.0±52.5 mL, P<0.001), drainage duration (81.9±6.1 h vs. 85.3±8.1 h, P=0.039), pain on the first day after surgery (4.6±0.7 vs. 5.4±0.7), P<0.001), pain on the second day (2.5±0.7 vs. 3.0±0.8, P=0.002), pain on the third day (1.1±0.8 vs. 1.5±0.6, P=0.014), postoperative activity time (40.7±6.7 h vs. 35.3±7.1 h, P<0.001), postoperative recovery time (6.8±0.9 d vs. 7.4±0.7 d, P=0.003), patient satisfaction (8.1±1.4 vs. 7.2±2.0, P=0.020) were significantly better than those of the control group with statistical differences. But there was no statistical difference in the conversion to thoracotomy between the two group. Conclusion MDT discussion can reduce the surgical risk and postoperative complications, improve the clinical efficacy and accelerate the postoperative rehabilitation of patients, which has a good clinical significance.

Citation： WANG Pengfei, DAI Weina, LIU Lixin, YUE Peng, HAN Biao. Analysis of the multidisciplinary team in the surgical treatment of lung cancer by video-assisted thoracoscopic surgery. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2019, 26(12): 1185-1189. doi: 10.7507/1007-4848.201903042 Copy

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2.	Jr MK, Houck W, Fuller CB. Video-assisted thoracic surgery lobectomy: experience with 1,100 cases. Ann Thorac Surg, 2006, 81(2): 421-425.
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5.	霍小东, 于振涛. 多学科团队在食管癌诊断与治疗中的作用. 中国肿瘤临床, 2016, 43(12): 502-506.
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10.	Mokhles S, Nuyttens JJME, De Mol M, et al. Treatment selection of early stage non-small cell lung cancer: the role of the patient in clinical decision making. BMC Cancer, 2018, 18(1): 79.
11.	袁瑛, 徐栋, 杨琦, 等. 直肠癌伴同时性多发性肺转移患者的多学科临床决策探讨. 中国肿瘤临床, 2017, 44(19): 973-978.
12.	Gandamihardja TAK, Soukup T, Mcinerney S, et al. Analysing breast cancer multidisciplinary patient management: a prospective observational evaluation of team clinical decision-making. World J Surg, 2018: 1-8.
13.	韦淑贞, 山顺林. 非小细胞肺癌多学科治疗的新进展. 现代肿瘤医学, 2010, 18(4): 828-830.
14.	Bydder S, Nowak A, Marion K, et al. The impact of case discussion at a multidisciplinary team meeting on the treatment and survival of patients with inoperable non-small cell lung cancer. Inter Med J, 2010, 39(12): 838-841.
15.	Emily S, Nicole R, Stephen K, et al. Does presentation at multidisciplinary team meetings improve lung cancer survival? Findings from a consecutive cohort study. Lung Cancer, 2018, 124: 199-204.
16.	Connolly MJ, Broad JB, Bish T, et al. Reducing emergency presentations from long-term care: A before-and-after study of a multidisciplinary team intervention. Maturitas, 2018, 117: 45-50.
17.	朱云柯, 林琳, 刘伦旭, 等. 中国胸外科围手术期疼痛管理专家共识(2018 版). 中国胸心血管外科临床杂志, 2018, 25(11): 921-928.
18.	Burden M, Thornton M. Reducing the risks of surgical site infection: the importance of the multidisciplinary team. Br J Nursing, 2018, 27(17): 976-979.
19.	曹雄, 蔺瑞江, 李仁鹏, 等. 多学科诊疗模式在非小细胞肺癌手术治疗过程中的应用价值. 中国胸心血管外科临床杂志, 2019, 26(8): 780-783.

1. Akhurst T. Staging of non-small-cell lung cancer. PET Clin, 2018, 13(1): 1-10.
2. Jr MK, Houck W, Fuller CB. Video-assisted thoracic surgery lobectomy: experience with 1,100 cases. Ann Thorac Surg, 2006, 81(2): 421-425.
3. 中华医学会, 中华医学会肿瘤学分会, 中华医学会杂志社. 中华医学会肺癌临床诊疗指南(2018 版). 中华肿瘤杂志, 2018, 40(12): 935.
4. Liu H, Song Y. MDT is still important in the treatment of early stage lung cancer. J Thorac Dis, 2018, 10(Suppl 33): S3984-S3985.
5. 霍小东, 于振涛. 多学科团队在食管癌诊断与治疗中的作用. 中国肿瘤临床, 2016, 43(12): 502-506.
6. 岳东升, 张华天. 非小细胞肺癌术后辅助治疗中国胸外科专家共识(2018 版). 中国肺癌杂志, 2018, 21(10): 14-20.
7. 陆小英, 赵存凤, 张婷婷, 等. “长海痛尺”在疼痛评估中的应用. 解放军护理杂志, 2003, 20(4): 6-7.
8. Barratt SL, Morales M, Spiers T, et al. Specialist palliative care, psychology, interstitial lung disease (ILD) multidisciplinary team meeting: a novel model to address palliative care needs. BMJ Open Respir Res, 2018, 5(1): e000360.
9. 张晓利. 泌尿肿瘤 MDT 中国创新模式“成长记”. 中国医院院长, 2018, (23): 42-44.
10. Mokhles S, Nuyttens JJME, De Mol M, et al. Treatment selection of early stage non-small cell lung cancer: the role of the patient in clinical decision making. BMC Cancer, 2018, 18(1): 79.
11. 袁瑛, 徐栋, 杨琦, 等. 直肠癌伴同时性多发性肺转移患者的多学科临床决策探讨. 中国肿瘤临床, 2017, 44(19): 973-978.
12. Gandamihardja TAK, Soukup T, Mcinerney S, et al. Analysing breast cancer multidisciplinary patient management: a prospective observational evaluation of team clinical decision-making. World J Surg, 2018: 1-8.
13. 韦淑贞, 山顺林. 非小细胞肺癌多学科治疗的新进展. 现代肿瘤医学, 2010, 18(4): 828-830.
14. Bydder S, Nowak A, Marion K, et al. The impact of case discussion at a multidisciplinary team meeting on the treatment and survival of patients with inoperable non-small cell lung cancer. Inter Med J, 2010, 39(12): 838-841.
15. Emily S, Nicole R, Stephen K, et al. Does presentation at multidisciplinary team meetings improve lung cancer survival? Findings from a consecutive cohort study. Lung Cancer, 2018, 124: 199-204.
16. Connolly MJ, Broad JB, Bish T, et al. Reducing emergency presentations from long-term care: A before-and-after study of a multidisciplinary team intervention. Maturitas, 2018, 117: 45-50.
17. 朱云柯, 林琳, 刘伦旭, 等. 中国胸外科围手术期疼痛管理专家共识(2018 版). 中国胸心血管外科临床杂志, 2018, 25(11): 921-928.
18. Burden M, Thornton M. Reducing the risks of surgical site infection: the importance of the multidisciplinary team. Br J Nursing, 2018, 27(17): 976-979.
19. 曹雄, 蔺瑞江, 李仁鹏, 等. 多学科诊疗模式在非小细胞肺癌手术治疗过程中的应用价值. 中国胸心血管外科临床杂志, 2019, 26(8): 780-783.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Analysis of the multidisciplinary team in the surgical treatment of lung cancer by video-assisted thoracoscopic surgery

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