Validation and Retrospection
Our culture has changed. Postoperative ambulation has been effectively inculcated into our postanesthesia care unit and our inpatient unit. The expectations have been set, and they are well established. At this point, a prospective, randomized study seems unethical given the logical progression from physiologic principles and mechanistic understanding. In order to limit variability, we retrospectively analyzed 208 consecutive patients undergoing thoracoscopic lobectomy from 2010 to 2014 and compared them to the most recently available 3-year data from the Society of Thoracic Surgeons (STS) database. There were no significant differences in baseline characteristics, although it should be noted that the STS database included both open and thoracoscopic interventions, as the database is not yet further stratified. In spite of this, the differences in length of stay, atrial arrhythmias, and pneumonia rates still seem remarkable.
Early postoperative ambulation should be considered in any thoracic surgical setting. The benefits to the patient and the program are far reaching and result in better outcomes, higher patient satisfaction, and more nursing integration and foster a collaborative relationship between medical personnel and administration (Schatz. AORN Journal. 2015;102:482).
Dr. Khandhar is Medical Director and Chief, Thoracic Surgery, Inova Fairfax Hospital; Director, Thoracic Oncology Program, Inova Health System; and Clinical Assistant Professor, Virginia Commonwealth University and Inova Fairfax Residency Program, Falls Church, Virginia.