Simultaneous bilateral video-assisted thoracic surgery is safe and feasible for multiple primary lung cancers

• Published in: Journal of cardiothoracic surgery 2024-07, Vol.19 (1), p.436-9, Article 436
• Main Authors: Yang, Libing, Guo, Chao, Zhang, Ye, Jiang, Huizhen, Ma, Lian, Liu, Hongsheng, Li, Shanqing
• Format: Article
• Language: English
• Subjects: Aged; Anesthesia; Cancer; Cardiac arrhythmia; Cardiovascular disease; Care and treatment; Chi-square test; Chronic obstructive pulmonary disease; Complications; Development and progression; Feasibility; Feasibility Studies; Female; Health services; Humans; Lung cancer; Lung diseases; Lung Neoplasms - pathology; Lung Neoplasms - surgery; Lung nodules; Lungs; Lymph nodes; Lymphatic system; Male; Medical records; Medical research; Medicine, Experimental; Middle Aged; Multiple primary lung cancers; Neoplasms, Multiple Primary - surgery; Nonsteroidal anti-inflammatory drugs; Pain management; Patients; Pneumonectomy - methods; Pneumothorax; Postoperative; Postoperative Complications - epidemiology; Respiratory diseases; Retrospective Studies; Risk factors; Simultaneous bilateral VATS; Smoking; Smoking and women; Surgeons; Surgery; Survival; Survival analysis; Thoracic surgery; Thoracic Surgery, Video-Assisted - methods; Thorax; Treatment Outcome; Tuberculosis
• ISSN: 1749-8090; 1749-8090
• DOI: 10.1186/s13019-024-02941-2

The treatment for bilateral synchronous multiple primary lung cancers (MPLC) remains challenging. Simultaneous bilateral video-assisted thoracic surgery (VATS) may be an optimal treatment with curative intent, but its safety and feasibility are controversial. One hundred and fifty-eight patients who underwent simultaneous bilateral VATS (simultaneous group) and 79 who underwent two-staged bilateral VATS (two-staged group) were included in this study. Their medical records were retrospectively reviewed and analyzed. The majority of patients were female and non-smokers. The most common surgical plan was lobectomy and contralateral wedge resection in both groups. There was no significant difference in the postoperative complication rate between the simultaneous groups and two-staged group (13.3% vs. 11.4%, p = 0.73). Patients who underwent simultaneous bilateral resection had shorter hospital stays, shorter anesthesia time and less chest drainage compared with those who underwent two-staged resection. Advanced TNM stage, complicated surgical plan and aggressive lymph node resection were risk factors for postoperative complications in simultaneous bilateral VATS. Patients in two groups had similar overall survival and disease free survival (p = 0.2). Simultaneous bilateral VATS for bilateral lung nodule resection is as safe and feasible as two-staged bilateral VATS. Patients who underwent simultaneous bilateral resection had similar or even better outcomes compared to that of the two-staged group. Simultaneous bilateral VATS is potentially an optimal treatment option for patients with erarly cTNM stage and good physical condition.