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Lobectomy Versus Sublobar Resection in Simultaneous Bilateral Thoracoscopic Lung Resection

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Abstract

Background

Simultaneous bilateral thoracoscopic lung resection (SBTLR) has been shown to be a feasible and efficacious approach for a wide range of pulmonary conditions. Our aim was to evaluate the impact of different procedures on surgical outcomes in patients receiving SBTLR.

Methods

Between 2012 and 2021, 207 patients with bilateral lung neoplasms who underwent SBTLR were retrospectively reviewed. Fifty-one patients received ipsilateral plus contralateral lobectomy or sublobectomy (lobar group), whilst 156 patients received bilateral sublobectomy (sublobar group). Propensity scores were calculated and matched. Perioperative and clinicopathologic outcomes were compared.

Results

The lobar group had a greater mean age (64.5 vs. 60.0 years, p = 0.008), longer operative time (254 vs. 205 min, p < 0.001), and more blood loss (74 vs. 46 ml, p < 0.001). The sublobar group had fewer complications (6.4 vs. 19.6%, p = 0.006), shorter hospital stay (4.8 vs. 7.4 days, p < 0.001), and lower hospital costs (p = 0.03). Among 50 pairs of matched groups, significant differences were found only in operative time, hospital stay, and costs. Maximum tumor size and pathological features differed significantly before and after matching (all p < 0.05), with the lobar group consistently demonstrating a larger main tumor (median, 2.5 cm) and a higher percentage of primary lung cancer (84%). Multivariate logistic regression analysis showed that a longer operative time was the factor associated with more complications (OR: 1.01; 95% CI 1.00–1.02, p = 0.002).

Conclusions

With regard to SBTLR, our data suggests that sublobectomy may reduce the prolonged recovery, hospital costs, and complications incurred by lobectomy, without compromising oncological outcomes.

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Acknowledgements

We thank Dr Jadzia Tin-Tsen Chou for her revision of the manuscript.

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Authors and Affiliations

  1. Division of Thoracic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, No. 100, Tzyou 1st Road, Kaohsiung, 80756, Taiwan

    Yu-Wei Liu, Chieh-Ni Kao, Hung-Hsing Chiang, Jui-Ying Lee, Hsien-Pin Li, Po-Chih Chang & Shah-Hwa Chou

  2. Department of Surgery, Tainan Municipal Hospital, Show Chwan Medical Care Corporation, Tainan, Taiwan

    Ming-Ho Wu

  3. Department of General Surgery, Royal Gwent Hospital, Aneurin Bevan University Health Board, Newport, Wales, UK

    Andre Chou

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  1. Yu-Wei Liu
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Correspondence to Shah-Hwa Chou.

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Human and animal rights

The IRB approved this study and the requirement for written informed consent was waived (KMUHIRB-E(I)-20200228, KMUHIRB-E(II)-20220192, SCMHIRB No. 1110413).

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Liu, YW., Wu, MH., Kao, CN. et al. Lobectomy Versus Sublobar Resection in Simultaneous Bilateral Thoracoscopic Lung Resection. World J Surg 47, 2568–2577 (2023). https://doi.org/10.1007/s00268-023-07081-7

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  • DOI: https://doi.org/10.1007/s00268-023-07081-7

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