@article{Karmacharya_Shakya_Singh_Baidya_Dahal_Shrestha_Bhandari_2020, title={Recovery Pattern in Different Surgical Approaches on Thoracic Enhanced Recovery based Fourteen-Step Protocol in Patients Undergoing Cardio-thoracic Surgery at University Hospital of Nepal}, volume={18}, url={https://www.nepjol.info/index.php/KUMJ/article/view/33260}, DOI={10.3126/kumj.v18i2.33260}, abstractNote={<p><strong>Background </strong>Cardio-thoracic surgery involves open and minimally invasive techniques. Enhanced recovery after surgery is used for early recovery from surgery. Enhanced recovery after surgery decreases hospital stay duration. Patients undergoing Enhanced recovery after surgery after video assisted thoracic surgery use less pain killers and have less hospital cost. There has not been any study on outcomes on patient who follow physiotherapy protocol designed in our setting.</p> <p><strong>Objective </strong>To find the physiotherapy outcomes in patients undergoing thoracic enhanced recovery after surgery (T-ERAS) based 14 step protocol locally designed at Dhulikhel Hospital, Kathmandu University Hospital (DH, KUH).</p> <p><strong>Method </strong>This is a retrospective cross sectional observational study. All the cases who underwent cardiothoracic surgery were classified based on the approach of chest surgery performed into groups Sternotomy, Thoracotomy and Video Assisted Thoracic Surgery (VATS) groups. Patients were advised for Thoracic Enhanced recovery after surgery based on the protocol that has been devised at Dhulikhel Hospital. The recovery of patients based on activities they could perform was noted and analyzed.</p> <p><strong>Result </strong>Both ICU stay and hospital stay in number of days were highest in thoracotomy (6.04 days) group while that was lowest in video assisted thoracic surgery group (1.67 days). There is a similar recovery until step 5, i.e. 2 days and rapid progression in further steps in video assisted thoracic surgery group while it is much slower in both sternotomy and thoracotomy groups.</p> <p><strong>Conclusion </strong>Postoperative mobilization and physiotherapy enhance early healing and decrease hospital stay. Mean hospital stay and ICU stay were shorter for video assisted thoracic surgery cases compared to Thoracotomy and Sternotomy groups and the mean days to achieve different steps varied within the protocol between groups compared.</p>}, number={2}, journal={Kathmandu University Medical Journal}, author={Karmacharya, R.M. and Shakya, R. and Singh, A.K. and Baidya, S. and Dahal, S. and Shrestha, P. and Bhandari, N.}, year={2020}, month={Dec.}, pages={78–82} }