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Simultaneous versus staged resections for bilateral pulmonary metastases.

Hope A Feldman1, Nicolas Zhou1, Mara B Antonoff1

  • 1Department of Thoracic and Cardiovascular Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.

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|March 8, 2021
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Simultaneous bilateral lung metastasectomy is a safe and efficient surgical option. This single procedure reduces hospital stays and operative time compared to staged resections, benefiting patients and healthcare resources.

Keywords:
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Area of Science:

  • Thoracic Surgery
  • Surgical Oncology
  • Pulmonary Medicine

Background:

  • Historically, staged resections were standard for bilateral pulmonary metastases.
  • The COVID-19 pandemic prompted exploration of alternative surgical approaches due to logistical and resource constraints.
  • This study investigates synchronous bilateral metastasectomies as a treatment for bilateral lung disease.

Purpose of the Study:

  • To evaluate the safety and efficacy of simultaneous bilateral metastasectomy.
  • To compare perioperative outcomes of simultaneous versus staged bilateral pulmonary metastasectomy.
  • To assess the impact on patient recovery and hospital resource utilization.

Main Methods:

  • Retrospective comparison of patients undergoing simultaneous bilateral metastasectomy versus staged resections.
  • Nearest-neighbor propensity score matching (1:1) to control for confounding factors.
  • Paired statistical analysis of perioperative outcomes, including length of stay, operative time, and complications.

Main Results:

  • 36 patients underwent simultaneous bilateral metastasectomies between 1998 and 2020; 31 pairs were matched.
  • Simultaneous resection significantly reduced length of stay (3 vs. 8 days) and operative time (156 vs. 235.5 minutes).
  • No significant differences in postoperative complication rates were observed between the groups.

Conclusions:

  • Simultaneous bilateral metastasectomy is a safe and viable surgical option for carefully selected patients.
  • A single-stage procedure offers advantages in patient recovery and hospital resource management.
  • This approach represents an efficient alternative to traditional staged resections for bilateral pulmonary metastases.