[Extended length of stay following robot-assisted minimally invasive pulmonary lobectomy: Is incomplete ERAS protocol to blame?]

Enhanced Recovery After Surgery (ERAS) is a series of measures designed to promote early recovery after surgery. Application of this approach has led to significantly decreased morbi-mortality and reduced length of hospital stay. The aim of our study was to determine whether non-completion of the ERAS protocol following robotic-assisted mini-invasive lobectomy could be the cause of prolonged hospital stay (exceeding 6 days). We conducted a longitudinal retrospective analysis of 34 patients (17 men and 17 women) having undergone robotic-assisted lobectomy for early-stage primary lung carcinoma from January 1, 2022 to December 31, 2022. The study population was divided into two groups based on length of hospital stay: group 1 with length of stay not exceeding 6 days and group 2 with a stay of 7 days or more. Comparative analysis showed no significant difference in ERAS completion score between the two groups, whatever the preoperative (P=0.15), perioperative (P=0.73) or postoperative (P=0.97) time. That said, prolonged air leak (P=0.01) was the main difference among the analyzed variables, followed by Charlson score (P=0.01), grade of complications (P=0.03) and smoking status (P=0.01). Incorporation of complementary measures in our ERAS protocol strategy would in all probability optimize air leak management and further reduce length of hospital stay.