Ayabe H, Tochiak H, Oka T, Hara S, Tagawa Y, Kawahara K, Tomita M
First Department of Surgery, Nagasaki University School of Medicine, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1991 Aug;39(8):1121-5.
From 1955 to April 1989, 70 patients underwent bilobectomy for the treatment of primary lung carcinoma. Thirteen patients (18.6%) underwent right upper and middle lobectomy (UML), while 57 patients (81.4%) underwent right middle and lower lobectomy (MML). Indications for bilobectomy were cancer invasion into intermediate bronchus (34%), tumor extending to neighbouring lobe across a fissure (29%), interlobar lymph nodes metastasis with or without invasion to intermediate bronchus (24%), vascular invasion (5%), and others (7%). Squamous cell carcinoma was present in 31 patients, adenocarcinoma in 28, large cell carcinoma in 5, small cell carcinoma in 4 and others in 2. About 60 percent of the patients had Stage III or IV diseases. Postoperative complications occurred in 27 patients (38.6%) and 3 died within 30 days after operation (operative mortality rate. 4.3%). Pneumonia, empyema, atelectasis and arrhythmia were prominent postoperative complications. There were no statistically different postoperative complication rates between those with UML and those of MLL. Five-year survival rate of the patients with bilobectomy for lung cancer was 25.7%, which was between those with single lobectomy (36.9%) and those with pneumonectomy (5.6%). However, there was no statistical difference in 5-year survival rate among operative procedures in each stage.