Single-Anesthesia Event for Lung Nodule Marking and Minimally Invasive Sublobar Resection

Background: Non-small cell lung cancer (NSCLC) accounts for a significant number of new lung cancer diagnoses each year, which, if identified early, may be surgically removed with curative intent. It is also the most common indication for a sublobar resection due to its equal efficacy in carefully selected patients. From the time of diagnosis to surgery, however, traditionally, there are three separate anesthesia-dependent events: (1) diagnostic bronchoscopy plus lymph node staging, (2) lung nodule marking, and (3) surgical resection. This study evaluated the viability of performing a pulmonary nodule marking and sublobar resection under a single-anesthesia-dependent event at a large community hospital. Methods: The study group was a single-center retrospective cohort of patients, scheduled for same-day marking and sublobar resection and admitted to a large community hospital between 6 January 2023 and 23 May 2023. Prior to arrival, patients had received cardiac surgical clearance, pulmonary function testing, and positron emission tomography to ensure their appropriateness for surgical intervention. Data regarding procedural time, anesthesia time, and hospital length of stay was collected retroactively though the electronic medical record. Results: A total of 12 patients with 16 pulmonary nodules were included. Results demonstrated a mean turnover time of 33 min between completing pulmonary fiducial marking and starting the sublobar resection. The estimated mean total time saved was 231 min. The average hospital length of stay was 1.83 days. Conclusions: Combining pulmonary fiducial marking and sublobar resection within a single-anesthesia-dependent event offers an opportunity to decrease total perioperative time and the time from diagnosis to curative intervention.