Enhanced recovery pathways in thoracic surgery from Italian VATS Group: preoperative optimisation

Preoperative patient optimisation is a key point of enhanced recovery after thoracic surgery pathways. This could be particularly advantageous when considering video-assisted thoracic surgery (VATS) lobectomy, because reduced trauma related to minimally invasive techniques is one of the main factors favouring improved postoperative outcome. Main speci c interventions for clinical optimisation before major lung resection include assessment and treatment of comorbidities, minimizing preoperative hospitalization, optimisation of pharmacological prophylaxis (antibiotic and thrombo-embolic) and minimizing preoperative fasting. Literature data and clinical evidences in this setting are reported and discussed.