Abstract
The value of applying enhanced recovery after surgery (ERAS) pathways in the perioperative management of lung cancer requires further high-level evidence. This study aimed to evaluate the impact of the ERAS nursing pathway on the recovery and prognosis of patients undergoing radical surgery for lung cancer. A retrospective cohort study design was adopted, including patients who underwent radical lung cancer surgery between January 2022 and January 2024. Based on the nursing model, patients were divided into an ERAS group (n = 121) and a conventional care control group (n = 170). Propensity score matching was used to control for confounding factors, resulting in 104 well-matched patients (52 in each group) for analysis. The ERAS group received multidisciplinary, standardized perioperative interventions. Hospital stay, recovery indicators, complications, quality of life (QoL), and patient experience were compared between the 2 groups. After matching, the postoperative hospital stay and total hospital stay in the ERAS group were significantly shorter than those in the control group (median: 5.0 days vs 8.0 days, P < .001; 9.0 days vs 13.0 days, P < .001). The ERAS group showed significantly earlier times to first ambulation, flatus, oral intake, and chest tube removal (all P < .001). Furthermore, the ERAS group had significantly lower overall complication rates (15.4% vs 36.5%, P = .012) and pulmonary complication rates (9.6% vs 25.0%, P = .035). Additionally, the ERAS group exhibited significantly lower postoperative pain scores, lower incidence of nausea and vomiting, while patient satisfaction and early postoperative QoL scores were significantly higher (all P < .05). Subgroup and sensitivity analyses yielded consistent results, confirming the robustness of the conclusions. For lung cancer patients undergoing radical surgery, implementing the ERAS nursing pathway can safely and effectively accelerate postoperative recovery, significantly shorten hospital stay, reduce the risk of complications, and improve patients' symptom experience and QoL, demonstrating significant clinical value for widespread promotion.