Journal of thoracic disease · 2026
A multidisciplinary comfort-enhanced recovery after surgery program improves perioperative patient-reported outcomes after lung cancer surgery: a randomized controlled trial.
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Li Hongjuan, Chen Lin, Zhou Lin, Zhang Qian, Wang Ke, Yu Zhonghua, Wang Wei, Lin Shanyu, Jiang Yayun, Jiang Yan
Аннотация
BACKGROUND: Patients undergoing lung cancer surgery frequently experience postoperative discomfort. Although enhanced recovery after surgery (ERAS) effectively reduces length of stay and complications, patients' subjective comfort is often underaddressed. The aim of this study is to evaluate the impact of a comfort-enhanced recovery after surgery (ComERAS) protocol on perioperative comfort, quality of life (QoL), and patient satisfaction among surgical lung cancer patients.
METHODS: A single-center, single-blind, randomized controlled trial design was employed. Patients were randomly assigned at a 1:1 ratio to the ComERAS group or the standard ERAS group. The ComERAS group received personalized comfort management provided by a multidisciplinary team, including preemptive multimodal analgesia, a "minimal-tube" strategy, early mobilization, traditional Chinese medicine interventions, and psychological support. Primary outcomes were General Comfort Questionnaire (GCQ) scores at discharge (T1). Secondary outcomes included GCQ score at 1 month postoperatively (T2), QoL, anxiety, depression and patient satisfaction. Analyses followed the intention-to-treat principle.
RESULTS: There were 134 participants randomized and 121 participants completed the 1-month follow-up. Compared with the ERAS group, the ComERAS group had significantly higher overall comfort scores at discharge (+1.05, P=0.01) and at 1 month (+0.57, P=0.006), improved self-care ability, and lower symptom burdens related to cough, pain, sleep, and fatigue (P<0.05). Moreover, the ComERAS group improved emotional function, overall QoL, and patient satisfaction (P<0.05).
CONCLUSIONS: The ComERAS protocol significantly improved perioperative comfort, emotional function, QoL, and patient satisfaction during the first postoperative month in patients after lung cancer surgery. These findings offer empirical evidence and a practical framework for shifting perioperative care from a "medicine-centered" to a "patient-experience-centered" approach. While supporting the immediate value of prioritizing comfort, further studies on extended follow-up and multicenter validation are warranted.
TRIAL REGISTRATION: Chinese Clinical Trial Registry ChiCTR2500109153.
METHODS: A single-center, single-blind, randomized controlled trial design was employed. Patients were randomly assigned at a 1:1 ratio to the ComERAS group or the standard ERAS group. The ComERAS group received personalized comfort management provided by a multidisciplinary team, including preemptive multimodal analgesia, a "minimal-tube" strategy, early mobilization, traditional Chinese medicine interventions, and psychological support. Primary outcomes were General Comfort Questionnaire (GCQ) scores at discharge (T1). Secondary outcomes included GCQ score at 1 month postoperatively (T2), QoL, anxiety, depression and patient satisfaction. Analyses followed the intention-to-treat principle.
RESULTS: There were 134 participants randomized and 121 participants completed the 1-month follow-up. Compared with the ERAS group, the ComERAS group had significantly higher overall comfort scores at discharge (+1.05, P=0.01) and at 1 month (+0.57, P=0.006), improved self-care ability, and lower symptom burdens related to cough, pain, sleep, and fatigue (P<0.05). Moreover, the ComERAS group improved emotional function, overall QoL, and patient satisfaction (P<0.05).
CONCLUSIONS: The ComERAS protocol significantly improved perioperative comfort, emotional function, QoL, and patient satisfaction during the first postoperative month in patients after lung cancer surgery. These findings offer empirical evidence and a practical framework for shifting perioperative care from a "medicine-centered" to a "patient-experience-centered" approach. While supporting the immediate value of prioritizing comfort, further studies on extended follow-up and multicenter validation are warranted.
TRIAL REGISTRATION: Chinese Clinical Trial Registry ChiCTR2500109153.