“One-Stop Shop” From Diagnosis to Resection for Suspicious Pulmonary Lesions: Early Outcomes From a Stage-Matched Comparative Study

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ID: 315727
2026
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Abstract
Abstract Background Since the first implementation of a CT-guided robotic navigation bronchoscopy program in Europe in our centre in July 2024, we have established a One-Stop Shop (OSS) concept for patients with suspicious pulmonary nodules, consisting of: Robotic-assisted navigation-bronchoscopy (ION) with integrated cone-beam CT, biopsy, marking of the nodule with fiducial and ICG, fresh-frozen examination and direct oncological resection in one general anaesthesia. Aims The idea behind the concept was to shorten patient pathways and reduce psychological burden during waiting times, which is proven to affect overall survival in NSCLC patients (1, 2). Methods Comparison of the first 37 patients undergoing our OSS concept to UICC-stage-matched (1:1) control group (n=37), in which patients had preoperative transbronchial biopsy or wedge-resection for diagnostic purposes. Time period was compared from first CT-scan with suspicious lesion to treatment. Results There was no relevant difference regarding median age (69.5 vs. 70 years; p=0.955) and gender (p=0.67) between the two groups. 43.2% percent of the patients had an UICC-Stage IA1, 32.4% IA2, 8.1% a pulmonary metastasis and 8.1% a benign finding (Figure 1A). In both groups, all surgeries were performed by a minimal-invasive approach (VATS/RATS). Time from first CT-scan with suspicious lesion to treatment was shorter in the OSS cohort (45 days vs. 58 days respectively, p=0.032). In a subgroup analysis of NSCLC patients, this effect was even more pronounced compared to the control group (45 days vs. 65 days, p=0.025) (Figure 1B). There was no difference in hospitalisation after resection between the groups (median 3 days for both, p=0.81) (Figure 1C). Conclusion Our OSS approach enables rapid diagnosis and treatment of potentially malignant pulmonary lesions in patients eligible for primary resection, minimizing delays in care. Furthermore, the OSS has the potential to reduce psychological stress in patients, which can positively impact survival rates. In this regard, an RCT is currently planned.
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Authors G M Monsch, D Schneiter, T Gaisl, C Steinack, K Chiffi, S Ulrich, O Lauk, I Opitz
Journal the british journal of surgery
Year 2026
DOI
10.1093/bjs/znag055.050
URL
https://doi.org/10.1093/bjs/znag055.050
Keywords Keywords not found

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