Lobectomy Versus Sublobar Resection in Simultaneous Bilateral Thoracoscopic Lung Resection.

Area of Science:

• Thoracic Surgery
• Surgical Oncology
• Pulmonary Medicine

Background:

• Simultaneous bilateral thoracoscopic lung resection (SBTLR) is a recognized approach for managing bilateral pulmonary conditions.
• Evaluating the impact of different surgical procedures on outcomes in SBTLR is crucial for optimizing patient care.

Purpose of the Study:

• To compare the perioperative and clinicopathologic outcomes of lobectomy versus sublobectomy in patients undergoing SBTLR for bilateral lung neoplasms.
• To determine if a less extensive surgical approach (sublobectomy) offers advantages over a more extensive one (lobectomy) in the context of SBTLR.

Main Methods:

• Retrospective review of 207 patients with bilateral lung neoplasms who underwent SBTLR between 2012 and 2021.
• Patients were divided into a lobar group (ipsilateral plus contralateral lobectomy/sublobectomy) and a sublobar group (bilateral sublobectomy).
• Propensity score matching was employed to compare perioperative outcomes, clinicopathologic features, complications, hospital stay, and costs.

Main Results:

• The lobar group exhibited older mean age, longer operative time, and greater blood loss compared to the sublobar group.
• The sublobar group demonstrated significantly fewer complications, shorter hospital stays, and lower hospital costs.
• While tumor size and pathological features differed, multivariate analysis identified longer operative time as a predictor of increased complications.

Conclusions:

• Sublobectomy in SBTLR appears to be associated with reduced recovery time, hospital costs, and fewer complications compared to lobectomy.
• The findings suggest that sublobectomy can be performed without compromising oncological outcomes in patients with bilateral lung neoplasms undergoing SBTLR.