# Next-Day Discharge Is Feasible in Robotic-Assisted Thoracic Surgery Anatomical Lung Resections Irrespective of Patient Characteristics

## TL;DR

The study shows that patients can be safely discharged the day after robotic lung surgery, regardless of age or health, if the procedure is short and there are no major complications.

## Contribution

It demonstrates that next-day discharge after robotic-assisted thoracic surgery is safe and not limited to only young or healthy patients.

## Key findings

- Next-day discharge patients had shorter surgeries and more sublobar resections.
- Morning theater slots and fewer major air leaks predicted next-day discharge.
- Re-admissions and complications were similar between next-day discharge and longer-stay patients.

## Abstract

Background: Next-day discharge post-robotic-assisted thoracic surgery (RATS) anatomical lung resections are shown to be achieved in young and fit patients. This study aims to compare next-day discharge RATS anatomical lung resection patients matched with patients who stayed longer. Methods: A retrospective analysis of patients who underwent RATS anatomical lung resection by a single surgeon was conducted. Based on the variables found to be different, two propensity-matched groups were created: a next-day discharge group and a group of patients with longer stays. Results: This study included 202 patients, 49 (24.3%) of whom were discharged the next day. The mean age was 68.3 ± 9.8 years, and 114 (56.4%) patients were females. Based on the variables found different, two matched groups with 46 patients for age, gender, performance score, American Society of Anesthesiologists score, number of co-morbidities and Forced Expiratory Volume in 1 sec were created. Re-admissions, complications, and death rates were similar, but next-day discharge patients had more sublobar resections (65.2% vs. 37%, p = 0.029), shorter procedures (132 vs. 179 min, p = 0.048), and morning theater slots (71.7% vs. 32.6, p = 0.018). These were shown to be independent predictors of next-day discharge. Major air leak issues also kept patients in the hospital longer (23.9% vs. 6.5%, p = 0.024). Conclusions: Next-day discharge following RATS anatomical lung resection appeared to have no increased risk of re-admissions or complications, irrespective of fitness, age, or other patient characteristics. Patients receiving short-duration surgery and morning sublobar resections without major air leak issues have higher chances of achieving next-day discharge.