Lu Zhang, Jiadong Guo, Xing Li, Ning Zhong, Jian Shu
Effective perioperative care is critical for optimizing outcomes after lung cancer surgery. This protocol details the implementation of a structured, multidisciplinary perioperative management bundle designed to enhance recovery and reduce complications. The protocol encompasses three phases: preoperative (including risk assessment, pulmonary rehabilitation, psychological support, and nutritional optimization), intraoperative (featuring lung-protective ventilation strategies), and postoperative (emphasizing early mobilization, multimodal analgesia, and continuous multidisciplinary team coordination). To assess the feasibility and potential impact of this protocol, it was applied to a cohort of patients undergoing lung cancer resection. Clinical outcomes, including postoperative complications, length of hospital stay, perioperative recovery quality, and short-term survival, were analyzed and compared with those receiving conventional perioperative care. The results indicated that high adherence to this comprehensive protocol was associated with a significant reduction in overall postoperative complications (10.0% vs. 29.1%, P < 0.001) and postoperative pneumonia (3.3% vs. 11.0%, P = 0.022). Although the hospital length of stay was statistically comparable between the groups (7.16 ± 3.32 days vs. 7.02 ± 3.66 days, P = 0.731), the comprehensive protocol group demonstrated vastly superior recovery efficiency, characterized by a substantial reduction in maximal acute pain scores (3.47 ± 1.01 vs. 5.17 ± 1.45, P < 0.001) and a major increase in patient satisfaction (91.82 ± 3.67 vs. 83.06 ± 6.13, P < 0.001) without compromising 30-day readmission safety. Most importantly, the protocol served as an independent protective factor that markedly improved 90-day survival (10.0% mortality vs. 29.9% in the conventional care group, P < 0.001). This article provides a step-by-step guide for implementing this multidisciplinary management protocol, supported by rigorously audited clinical outcome data, serving as a practical operational framework for other institutions aiming to standardize and improve perioperative care pathways and short-term survival tracking in thoracic surgery.