ArticleUpdates in surgery2026
Safety and cost-effectiveness of day surgery in Da Vinci-assisted pulmonary segmentectomy.
Article in Updates in surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Day surgery enhances resource utilization via enhanced recovery after surgery, but its role in robot-assisted pulmonary segmentectomy is unclear. This study assessed its safety, efficacy, and economic value to support broader clinical adoption. We retrospectively reviewed 341 patients who underwent Da Vinci robot-assisted pulmonary segmentectomy at our hospital between January 2021 and December 2024. Patients were divided into a day surgery group (N = 142) and an inpatient group (N = 199) based on perioperative management protocols following enhanced recovery after surgery (ERAS) principles, including preoperative assessment, inpatient care, and structured postoperative follow-up. Propensity score matching (1:1) with a caliper width set at 0.20 standard deviations was performed using covariates, including sex, age, radiological T stage, smoking history, prior thoracic/abdominal surgery, nodule location, segment complexity and lymph node dissection/sampling sites. After matching, 166 patients were analyzed for perioperative outcomes and postoperative complications. Compared with the inpatient group, the day surgery group had significantly less intraoperative blood loss [30 (30–50) vs. 50 (30–50) mL], shorter chest tube durations [38 (36–40) vs. 41 (39–65) hours], shorter hospital stays [47.0 (46.0–48.0) vs. 92.5 (84.3–111.8) hours], and lower total costs [8776 (6121–9769) vs. 12182 (10960–13474) USD] (all P < 0.05). No significant differences were observed in the operative time, drainage volume, pain score, postoperative complication rate, or 1-month pleural events (all P > 0.05). With standardized perioperative management, Da Vinci robot-assisted pulmonary segmentectomy performed as day surgery is safe, feasible, and cost effective. These findings support its further application in clinical thoracic surgical practice.
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