Factors Associated With Next-Day Discharge After Pulmonary Lobectomy

As surgical treatment of lung cancer continues to improve, the focus is now on improving patient outcomes. We aimed to determine the factors that play a role in discharge the day after pulmonary lobectomy.

We performed a retrospective cohort study of patients who underwent lobectomy. We compared outcomes between patients who were discharged the next day and those who had longer hospital stays. Logistic regression modeling was performed to determine the characteristics associated with next-day discharges.

There were 591 patients who underwent lobectomy performed by 5 surgeons, of whom 270 (45.7%) were male with a median age of 69 years. Most patients underwent surgery by the da Vinci Xi robotic system (n = 491 [83.1%]), and 72 (12%) were discharged the next day. Patients who were discharged the next day had significantly fewer complications (6.9% vs 34.9%; P < .01), without a difference in the 30-day readmission rate (6.9% vs 7.3%; P = 1) or 30-day mortality (0% vs 0.4%; P =1). Multivariate logistic regression showed that surgeon (odds ratio, 3.60; 95% CI, 1.94-6.66) and the da Vinci Xi robotic approach (odds ratio, 9.79; 95% CI, 2.25-42.61) were 2 modifiable independent predictors of next-day discharge.

The next-day discharge after pulmonary lobectomy was safe. Patients operated on by experienced surgeons using the da Vinci Xi robot were more likely to be discharged the following day. Gaining experience in performing robotic lobectomy may help ensure safe, next-day discharge after pulmonary lobectomy.