Single-stage video-assisted thoracoscopic surgery: Right upper lobectomy and left lower lobectomy for synchronous bilateral lung cancers.

INTRODUCTION

Single-stage bilateral radical surgery for synchronous bilateral multiple lung cancers (SBMLCs) has strong advantages; however, it is considered highly invasive. We have therefore adopted video-assisted thoracoscopic surgery (VATS) as a minimally invasive surgical maneuver for bilateral lung resection. Although there have been a few reports concerning bilateral lung resection, the safety and appropriate operative indications remain unclear, especially for bilateral VATS-lobectomy. A case of single-stage bilateral radical lobectomy with a good result is reported.

PRESENTATION OF CASE

A 58-year-old man was found to have abnormal opacities in the right upper zone and left lower zone at a health checkup. Double primary bilateral lung cancers was suspected, and surgical resection was considered. Consequently, right upper lobectomy with D2 lymph node dissection and left lower lobectomy with D2 lymph node dissection as radical resection were performed under VATS. The lesions were finally diagnosed to be double primary adenocarcinomas of the right upper lobe (pT1N0M0, stage IA) and left lower lobe (pT1N0M0, stage IA). The patient's postoperative course was uneventful, and he was discharged on postoperative day 6. The patient is doing well with no evidence of recurrence for 9 years.

CONCLUSION

While careful consideration of the surgical options is needed, if properly done, bilateral VATS-lobectomy for SBMLC has advantages for selected patients.