Cryoablation during lobectomy for lung cancer appears to be a safe and cost-effective strategy for easing postoperative pain, according to a study published in Pain and Therapy.

“Cryoablation is performed by the surgeon intraoperatively by freezing intercostal nerves during the procedure. The adjunctive ablation induces cell damage and temporarily disrupts nerve conduction, while axons regenerate,” Daniel Miller, MD, and colleagues wrote. “This allows for a pain-free period promoting complete rapid recovery and reduces the risk for pain-related complications.”

Postsurgical pain after lobectomy is challenging to treat, especially for patients with a history of opioid use, the researchers noted. The study investigated the effect of intraoperative cryoablation performed during lung cancer surgery on patient outcomes, opioid use, and hospital costs.

Using a retrospective cohort of surgical patients from a US national all-payer database, Dr. Miller and colleagues matched 266 pairs of patients who did and did not receive ancillary cryoablation during lobectomy. Patients were matched for age, sex, lobe resected, and prior opioid use.

Study Findings

 e average patient age was 69 years, and both the cryoablation and the no-cryoablation groups had a 50% or higher proportion of patients with a history of chronic obstructive pulmonary disease, hypertension, smoking, and past year opioid use. In both groups, 66% of patients underwent open lobectomy, and 53% had the upper lobe resected.

Cryoablation was associated with a 1.3-day shorter hospital stay, according to the study findings. Specifically, lengths of stay averaged 8.8 days in the cryoablation group and 10.1 days in the no-cryoablation group. Perioperative safety outcomes, such as prolonged air leak, pneumothorax, major bleed, and atrial fibrillation, did not diff er between groups.

At 90 days after surgery, opioid use was 26% lower for the cryoablation group. In the 6 months after surgery, the proportion of patients with outpatient hospital visits was 83.1% in the cryoablation group compared with 92.9% in the no-cryoablation group.

Costs for the index stay trended lower with than without cryoablation ($38,753 vs $43,974), the researchers found. Total costs also remained lower for patients who did versus those who did not receive cryoablation through 6 months of follow-up: $65,703 compared with $74,304.

“Cryoablation in this study impacted both index and long-term healthcare costs positively,” Dr. Miller and colleagues wrote. “ ese results are important given the challenge of hospitals and payors to support the incremental cost of ancillary procedures added to primary procedure to improve outcomes.”