Combining Robotic Navigational Bronchoscopy and Lung Resection Into a Single Anesthetic Event: Cost-Effectiveness,...

Delay from diagnosis to resection in non-small cell lung cancer negatively affects survival. Single-anesthesia robotic navigational bronchoscopy with biopsy and lung resection (SABR) was developed to mitigate delay. We report outcomes, wait times, and cost effectiveness of this approach vs staggered robotic navigational bronchoscopy followed by resection.

Patients undergoing SABR or staggered biopsy and resection between April 2020 and May 2023 were included. Demographic and procedural characteristics were collected for both groups. Time from clinic and biopsy to operation, length of stay, and inpatient complications were captured. Direct, indirect, and total costs, adjusted to 2023 dollars, were measured for each case.

The study included 40 patients in the SABR group and 30 patients in the staggered group. Baseline clinical characteristics including pathologic stage were similar between the groups. No difference was found in rates of complications. Time from clinic to resection was 26.5 days in the SABR group and 41.5 days in the staggered group (P = .001). Time from biopsy to resection was 0 days for the SABR group, whereas it was 17 days for the staggered group (P < .001). The SABR group had lower adjusted direct cost ($37,154 vs $41,678; P = .005), indirect cost ($33,450 vs $39,706; P = .004), and total cost ($70,591 vs $81,025; P = .004).

Our experience suggests that the SABR technique offers a significant reduction in the time from diagnosis to treatment as well as reduces cost of care for patients with early-stage non-small cell lung cancer.