Our Summary

The study focuses on the cost and resource usage of three different types of lung volume reduction surgery (LVRS), a procedure used to ease symptoms in people with severe lung disease. These three types are: endobronchial valve insertion (EBV-LVRS), video-assisted thoracic surgery (VATS-LVRS), and robotic-assisted thoracic surgery (RATS-LVRS).

The researchers developed a model to track hospital resource use from the decision to perform the LVRS until 90 days after the patient was admitted to the hospital. They used information from previous studies, electronic health records, and expert opinions. The cost of each resource was taken from the hospital’s finance department and reported in 2021 Euros.

The study found that VATS-LVRS was the least expensive method, costing €12,896 per patient. In comparison, EBV-LVRS was the most expensive, at €15,598 per patient, with RATS-LVRS in the middle, at €13,305 per patient. A significant portion of the cost for EBV-LVRS came from complications and the need for additional surgery.

This study provides a detailed framework for analyzing the cost and hospital resources used for these three types of surgery. This can be used by health service providers, hospital managers, and clinicians to identify ways to reduce resource use (such as changing the makeup of surgical teams, using staff and supplies more efficiently, planning for the length of stay, and reducing the need for additional surgery) and to understand the potential cost implications of such changes.

FAQs

  1. What are the three types of lung volume reduction surgery (LVRS) that the study focused on?
  2. Which type of LVRS was found to be the least expensive and which was the most expensive?
  3. How can this study’s framework be used by health service providers and hospital managers?

Doctor’s Tip

One helpful tip a doctor might tell a patient about lung surgery is to follow all pre-operative instructions provided by the healthcare team, such as quitting smoking, maintaining a healthy diet, and staying physically active. This can help improve surgical outcomes and reduce the risk of complications during and after surgery. Additionally, it is important to communicate openly with your healthcare team about any concerns or questions you may have before and after the surgery.

Suitable For

Patients who are typically recommended lung surgery include those with severe lung disease, such as chronic obstructive pulmonary disease (COPD), emphysema, or severe asthma, who have not responded well to other treatments such as medication, pulmonary rehabilitation, or oxygen therapy. These patients often experience symptoms such as difficulty breathing, chronic cough, chest tightness, and fatigue, which significantly impact their quality of life and ability to perform daily activities. Lung surgery may be recommended to help improve lung function, alleviate symptoms, and potentially prolong survival in these patients.

Timeline

Before lung surgery:

  1. Patient undergoes a series of tests and evaluations to determine the severity of their lung disease and if surgery is necessary.
  2. Patient meets with a surgeon to discuss the different types of lung surgery available and the risks and benefits associated with each.
  3. Patient is scheduled for the chosen surgery and instructed on pre-operative preparations, such as fasting and medication adjustments.

After lung surgery:

  1. Patient is admitted to the hospital and undergoes the surgery, which may involve different techniques depending on the type of surgery chosen (EBV-LVRS, VATS-LVRS, RATS-LVRS).
  2. Patient is closely monitored in the recovery room before being transferred to a hospital room for further observation.
  3. Patient may experience pain, discomfort, and difficulty breathing in the days following surgery.
  4. Patient undergoes physical therapy and respiratory therapy to aid in recovery and improve lung function.
  5. Patient is discharged from the hospital and continues follow-up care with their surgeon and primary care physician.
  6. Patient gradually resumes normal activities and may experience improvements in their lung function and quality of life.

What to Ask Your Doctor

Some questions a patient should ask their doctor about lung surgery include:

  1. What type of lung surgery do you recommend for my condition?
  2. What are the potential risks and complications associated with the surgery?
  3. How long will the recovery process be, and what can I expect during that time?
  4. What are the expected outcomes of the surgery in terms of symptom improvement and quality of life?
  5. How experienced are you in performing this type of surgery?
  6. What is the success rate of this type of surgery for patients with similar conditions to mine?
  7. How long will I need to stay in the hospital after the surgery?
  8. What kind of follow-up care will I need after the surgery?
  9. What are the potential costs associated with the surgery, including any additional procedures or treatments that may be required?
  10. Are there any alternative treatment options available for my condition?

Reference

Authors: Mulryan K, Sorensen J, Waller D, Redmond K. Journal: Eur J Cardiothorac Surg. 2024 Jun 3;65(6):ezae222. doi: 10.1093/ejcts/ezae222. PMID: 38833683