OBJECTIVE The goal of this study is to investigate the use of EA and its impact on the postoperative short-term outcomes of patients with non-small cell lung cancer (NSCLC) who received a lobectomy by either minimally invasive surgery (MIS) or thoracotomy. MATERIALS AND METHODS We investigated 793 patients who underwent lobectomy for pathological stage I-III NSCLC without induction therapy during two time periods, an early-time period (2009-2010: MIS, n = 204 [53%]; and thoracotomy, n = 182 [47%]) and a late-period (2014-2015: MIS, n = 308 [76%]; and thoracotomy, n = 99 [24%]). Patient characteristics, including pulmonary function tests, comorbidities, and use of EA, as well as short-term outcomes, including length of stay, morbidity, and mortality were assessed and compared between early-and late-time periods. We also compared patients who received EA (n = 150) with patients who did not receive EA (n = 158) following MIS lobectomy in the late-time period. RESULTS The use of MIS lobectomy increased during the late-time period compared to the early-time period (p < 0.001). In patients who underwent MIS lobectomy, the use of EA significantly decreased in the late-time period compared to the early-time period (2009-2010 vs. 2014-2015, 95% vs. 51%; p < 0.001). There was no difference in postoperative morbidity and mortality between the two time periods in both MIS and thoracotomy. In the late-time period MIS group, the length of stay in the no EA group (n = 150) was shorter than that in the EA group (n = 158) (3 vs. 4 days, p = 0.038). There was no difference in morbidity and mortality between the EA and no EA groups. CONCLUSION In our study cohort, the observed decrease in the use of EA with the increasing rate of MIS lobectomy did not negatively affect postoperative short-term outcomes.

中文翻译：

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减少硬膜外镇痛的使用并增加微创肺叶切除术：对术后发病率的影响。

目的本研究的目的是调查EA的使用及其对通过微创手术（MIS）或开胸手术接受了肺叶切除术的非小细胞肺癌（NSCLC）患者术后短期预后的影响。材料与方法我们调查了793例在两个时期（早期时期（2009-2010年：MIS，n = 204 [53％]；开胸手术，n = 182 [47％]）和后期（2014-2015：MIS，n = 308 [76％]；开胸手术，n = 99 [24％]）。评估并比较了早期和晚期患者的特征，包括肺功能检查，合并症和EA的使用，以及短期结局，包括住院时间，发病率和死亡率。我们还比较了在晚期MIS肺叶切除术后接受EA（n = 150）的患者与未接受EA（n = 158）的患者。结果与早期相比，MIS肺叶切除术的使用在后期阶段有所增加（p <0.001）。在接受MIS肺叶切除术的患者中，与早期相比，晚期使用EA的时间明显减少（2009-2010年与2014-2015年相比，分别为95％和51％； p <0.001）。MIS和开胸手术在两个时间段之间的术后发病率和死亡率无差异。在晚期MIS组，无EA组（n = 150）的住院时间短于EA组（n = 158）（3天对比4天，p = 0.038）。EA组和无EA组之间的发病率和死亡率无差异。结论在我们的研究队列中，