Réhabilitation rapide après chirurgie de résection pulmonaire

Lung resection surgery is the primary treatment of non small cells lung cancer. This surgical procedure conveys a high risk of complications. A fast-track pathway aims at reducing perioperative morbidity. Despite the limited number of heterogeneous studies dedicated to various fast-tracking programs, after lung surgery a reduction in postoperative morbidity and hospital length of stay has been documented without an increasing readmission rate and supplementary cost. In lung surgery, fast-track programs include smoking cessation, optimization of analgesia and chest tube management and chest physiotherapy. Smoking cessation documents benefit even within a short delay before surgery. Postoperative pain control is provided by a regional analgesic technique associated to systemic analgesia. The number and the duration of chest tubes placement should be limited. Chest physiotherapy begins preoperatively and is continued postoperatively. Early ambulation is promoted within the first 24 hours after surgery.