Matsubara Taichi, Toyokawa Gouji, Kinoshita Fumihiko, Haratake Naoki, Kozuma Yuka, Akamine Takaki, Takamori Shinkichi, Hirai Fumihiko, Tagawa Tetsuzo, Okamoto Tatsuro, Maehara Yoshihiko
Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
Anticancer Res. 2018 Mar;38(3):1715-1719. doi: 10.21873/anticanres.12406.
We investigated the safety of simultaneous bilateral lung resection for lung metastases.
We retrospectively analyzed 185 patients with pulmonary metastases who underwent unilateral or bilateral pulmonary resection from August 2009 to December 2016 at a single institution.
Single-stage bilateral lung resection was undertaken in 19 patients, and the other 166 patients underwent unilateral pulmonary resection, including 20 patients who underwent repeated resections for synchronous or metachronous metastases. Operative time and drainage days in the bilateral group were significantly longer than those in the unilateral group (220±20 vs. 152±6.9 min: p<0.01, and 2.79±0.3 vs. 2.08±0.1 days: p<0.01). Incidence of postoperative complications and postoperative in-hospital days did not differ between the two groups (p=0.33 and 0.66, respectively). The bilateral group was further divided into two groups, namely, those who underwent wedge resection on both sides (WW) and those who underwent wedge resection on one side and segmentectomy or lobectomy on an opposite side (WSL). Operative time in the WSL group was significantly longer than that in the WW group (260±19 vs. 201±18 min: p=0.03). However, there was no significant difference in duration of chest tube use and postoperative hospital days between the two groups (p=0.26 and p=0.89). No severe postoperative complications occurred in either group.
One-stage bilateral pulmonary metastasectomy appears to be safe as long as only wedge resection is performed on at least one side.
我们研究了同期双侧肺切除治疗肺转移瘤的安全性。
我们回顾性分析了2009年8月至2016年12月在一家机构接受单侧或双侧肺切除的185例肺转移瘤患者。
19例患者接受了一期双侧肺切除,其他166例患者接受了单侧肺切除,其中20例患者因同步或异时转移接受了重复切除。双侧组的手术时间和引流天数明显长于单侧组(220±20对152±6.9分钟:p<0.01,以及2.79±0.3对2.08±0.1天:p<0.01)。两组术后并发症发生率和术后住院天数无差异(分别为p=0.33和0.66)。双侧组进一步分为两组,即双侧均行楔形切除术的患者(WW)和一侧行楔形切除术而另一侧行段切除术或肺叶切除术的患者(WSL)。WSL组的手术时间明显长于WW组(260±19对201±18分钟:p=0.03)。然而,两组胸管使用时间和术后住院天数无显著差异(p=0.26和p=0.89)。两组均未发生严重的术后并发症。
只要至少一侧仅行楔形切除术,一期双侧肺转移瘤切除术似乎是安全的。