Clinical and Operational Impact of Single Anesthesia Events in the Surgical Management of Early-Stage Lung Cancer

Background: To evaluate whether single anesthesia events (SAE), which combine diagnosis (via robotic bronchoscopy) and treatment (via robotic surgery), reduce time to treatment interval (TTI) and cost compared to the standard of care in early-stage lung cancer patients.

Methods: Early-stage lung cancer patients who underwent biopsy and resection from October 2021 to August 2024 were identified and grouped by surgical event: SAE vs. traditional. SAE patients underwent robotic biopsy, pathologic evaluation, and robotic resection in the same anesthetic encounter. Traditional patients underwent robotic biopsy on a separate day before robotic resection. Patient characteristics and outcomes were retrospectively compared.

Results: Total of 61 patients (42 traditional, 19 SAE) were included. Patient characteristics had no significant difference. Median pathological nodule size (cm) was lower in the SAE cohort (1.5 vs 2.1; p = 0.0342). Median time from diagnostic CT to resection was 84.5 days for traditional patients vs. 48.0 days for SAE patients (p < 0.0001). Median time from initial pulmonologist consultation to resection was 62.5 days for traditional patients vs. 38.0 days for SAE patients (p = 0.0021). There was no significant difference in cost between the two.

Conclusions: Compared with the traditional pathway, the more streamlined SAE approach was associated with a significantly shorter time to treatment interval without increased direct costs. These findings suggest that SAE may represent an operationally efficient approach to the management of selected patients with early-stage lung cancer, although larger studies are needed to assess quality-of-life benefits and to confirm the clinical & operational implications.