Effect of Surgical Day of Week on Postoperative Outcomes After Robotic-Assisted Pulmonary Lobectomy

Hudson Ash-Rafzadeh; Tilman J Chambers; Frank O Velez; Carla C Moodie; Joseph R Garrett; Jacques P Fontaine; Eric M Toloza

doi:10.7759/cureus.35379

Effect of Surgical Day of Week on Postoperative Outcomes After Robotic-Assisted Pulmonary Lobectomy

Cureus. 2023 Feb 23;15(2):e35379. doi: 10.7759/cureus.35379. eCollection 2023 Feb.

Authors

Hudson Ash-Rafzadeh¹, Tilman J Chambers¹, Frank O Velez², Carla C Moodie³, Joseph R Garrett³, Jacques P Fontaine^{3

4}, Eric M Toloza^{3

4}

Affiliations

¹ Department of Medical Education, University of South Florida Health Morsani College of Medicine, Tampa, USA.
² Department of Surgery, University of South Florida Health Morsani College of Medicine, Tampa, USA.
³ Department of Thoracic Oncology, Moffitt Cancer Center, Tampa, USA.
⁴ Departments of Surgery and of Oncologic Sciences, University of South Florida Health Morsani College of Medicine, Tampa, USA.

Abstract

Introduction Patients who have surgery late in the week could potentially receive different postoperative care due to a reduced weekend staff compared to patients who have surgery early in the week, who will be cared for by a full staff during the work week. Our aim was to determine if patients who underwent robotic-assisted video-thoracoscopic (RAVT) pulmonary lobectomy during the first half of the week had different outcomes than patients who also underwent RAVT pulmonary lobectomy during the second half of the week. Methods We analyzed 344 consecutive patients who underwent RAVT pulmonary lobectomy by one surgeon from 2010 to 2016. Depending on the day of the surgical procedure, these patients were either put into a Monday through Wednesday (M-W) group or a Thursday through Friday (Th-F) group. Patient demographics, tumor histopathology, intraoperative and postoperative complications, and perioperative outcomes were compared between groups using the Student's t-test, Kruskal-Wallis test, or chi-square (or Fisher's exact) test, with p≤0.05 as significant. Results There were more non-small cell lung cancers (NSCLCs) resected in the M-W group than in the Th-F group (p=0.005). Skin-to-skin and total operative times were greater for the Th-F group than for the M-W group (p=0.027 and p=0.017, respectively). There were no significant differences in any other variables assessed. Conclusions Our study showed that, despite reduced weekend staffing and potential differences in postoperative care, there were no significant differences seen in postoperative complications or perioperative outcomes based on surgical day of the week.

Keywords: patient-centered outcomes research; perioperative outcomes; pulmonary lobectomy; robotic surgical procedures; thoracic oncosurgery.

Grants and funding

This study was supported in part by the 2018 and 2020 Summer Scholarly Awards to Tilman J. Chambers and to Hudson Ash-Rafzadeh, respectively, from the Scholarly Concentrations Program of the Office of Research, Innovation, and Scholarly Endeavors (RISE) of the University of South Florida (USF) Morsani College of Medicine, Tampa, USA. There were no other sources of funding/support.