Ability of single anesthesia for combined robotic-assisted bronchoscopy and surgical lobectomy to reduce time between detection and treatment in stage I non-small cell lung cancer

• Published in: Proceedings - Baylor University. Medical Center 2023, Vol.36 (4), p.434-438
• Main Authors: Wolf, Adam J., Miller, Paige M., Burk, John R., Vigness, Richard M., Hollingsworth, John W.
• Format: Article
• Language: English
• Subjects: Biopsy; Bronchoscopy; Identification; Lung cancer; malignancy; navigation; Original Research: Oncology; Robotics; single anesthesia; Thoracic surgery
• ISSN: 0899-8280; 1525-3252
• DOI: 10.1080/08998280.2023.2193134

Background: Early identification, diagnosis, and treatment of lung cancer is associated with improved clinical outcomes. Robotic-assisted bronchoscopy improves the ability to diagnose early stage lung malignancies and, when combined with robotic-assisted lobectomy under single anesthesia, could reduce time from identification to intervention in early stage lung cancer in a select patient population. Methods: A retrospective case-control single-center study compared patients with radiographic stage I non-small cell carcinoma (NSCCA) undergoing robotic navigational bronchoscopy and surgical resection (N = 22) with historical controls (N = 63). The primary outcome was time from initial radiographic identification of a pulmonary nodule to therapeutic intervention. Secondary outcomes included times between identification to biopsy, biopsy to surgery, and procedural complications. Results: Patients with suspected stage I NSCCA who received single anesthesia for diagnosis and intervention with robotic-assisted bronchoscopy and robotic-assisted lobectomy had shorter times between identification of a pulmonary nodule and intervention compared to controls (65 vs 116 days, P = 0.005). Cases had lower rates of complications (0% vs 5%) and shorter hospitalizations after surgery (3.6 vs 6.2 days, P = 0.017). Conclusion: Our findings support that implementing a multidisciplinary thoracic oncology team and single-anesthesia biopsy-to-surgery approach in management of stage I NSCCA significantly reduced times from identification to intervention, biopsy to intervention, and length of hospital stays in management of lung cancer.