Synchronous Surgical Therapy for Bilateral Multiple Pulmonary Nodules: A Single-Center Analysis of 108 Cases

With the widespread use of low-dose computed tomography (LDCT), the detection rate of bilateral multiple pulmonary nodules (BMPNs) has increased significantly. Surgical treatment remains the main treatment for multiple pulmonary nodules (MPNs), and its therapeutic value for simultaneous BMPNs is becoming increasingly prominent. However, the safety and feasibility of synchronous bilateral surgery (SBS) remain underexplored. This study aimed to evaluate the perioperative outcomes and prognosis of patients who underwent SBS for multiple pulmonary nodules.

We retrospectively analyzed the data from 108 patients who underwent synchronous bilateral resection for MPNs at Peking University Third Hospital between January 2015 and December 2025. Clinical, pathological, and perioperative data were collected. Postoperative complications were classified using the Clavien-Dindo system. Risk factors for postoperative complications were identified using a logistic regression analysis. Overall survival was estimated using the Kaplan-Meier method.

Among the 108 patients, 62.0% were female, and 79.6% were nonsmokers. The most common surgical combination was wedge resection combined with wedge resection (44.4%). The mean postoperative hospital stay was 6.55 ± 3.03 days. The most common complications were constipation (53.7%) and sleep disorders (51.9%), while severe complications occurred in fewer than 5% of the patients. No 30-day mortality or unplanned secondary surgery was observed. Prolonged chest tube drainage (> 3 days) was identified as an independent risk factor for grade ≥ 2 complications (p < 0.05). The 5-year overall survival rate was 92.3%.

SBS for MPNs is safe and feasible in selected patients, with acceptable perioperative outcomes and favorable survival.