The Outcome of Bilateral Lung Cancer Patients Who Underwent One-stage Thoracoscopic Surgery

This study is aimed to clarify the risks and the overall survival rate of bilateral lung cancer patients who underwent one-stage thoracoscopic surgery. Here, we retrospectively reviewed the lung cancer patients who were operated on by a single surgeon from the electronic medical records. The bilateral lung cancer patients who underwent one-stage thoracoscopic surgery were enrolled in the study. From February 2012 to June 2022, a total of 362 lung cancer patients underwent thoracoscopic curative surgery. Among them, 27 (7.4%) bilateral lung cancer patients underwent one-stage bilateral thoracoscopic surgery. These bilateral lung cancer patients were older than the unilateral lung cancer patients (69.9 ± 1.9 vs 63.4 ± 0.60 years old, p = 0.019). More females than males had bilateral lung cancer compared to the unilateral lung cancer patients (18/27, 66.6% vs 169/335, 50.4%, p = 0.077). Among these 27 bilateral lung cancer patients, 14 (51.8%) patients were recognized as having synchronous bilaterally primary lung cancers, including six patients with different cell types of lung cancer on each side. Thirteen (48.1%) patients were identified as having lung-to-lung metastasis, including three patients having intrathoracic lymph node metastasis. The average operating time was 228.5 minutes, ranging from 165 to 328 minutes. The average operative blood loss was 155.9 mL, ranging from 10 to 1850 mL. The average postoperative hospital stay was 5.66 ± 0.81 days, which was similar to that of unilateral lung cancer patients (5.67 ± 0.19 days, p = 0.998). There was no surgical morbidity or operative death. The overall survival of patients with synchronous bilaterally primary lung cancer was not significantly different from the patients with stage 2 (p < 0.001). Collectively, surgical risks of one-stage bilateral thoracoscopic surgery for bilateral lung cancers are rare and the overall survival rate is acceptable.

關鍵字

Thoracoscopic surgery ； One-stage bilateral lung surgery ； Bilateral lung cancer

並列摘要

本研究的目的為探討雙側肺癌患者接受同一次胸腔鏡手術的風險和總生存率。我們從電子病歷中回顧性地回顧了由一名外科醫師進行手術的肺癌病人。雙側肺癌病人被納入研究。2012年2月至2022年6月，共有362例肺癌病人接受了胸腔鏡手術。結果顯示其中27例（7.4%）雙側肺癌病人接受了同一次雙側胸腔鏡手術。這些雙側肺癌病人的年齡大於單側肺癌病人（69.9 ± 1.9 vs 63.4 ± 0.60歲, p = 0.019）。與單側肺癌病人相比，患有雙側肺癌的女性多於男性（18/27, 66.6% vs 169/335, 50.4%, p = 0.077）。在這27例雙側肺癌患者中，14例（51.8%）患者被確認為同時性原發性肺癌，其中每側有6例不同細胞類型的肺癌患者。13名（48.1%）患者被確定為肺間轉移，其中3名患者出現胸內淋巴結轉移。平均手術時間為228.5分鐘，從165分鐘到328分鐘不等。平均手術失血量為155.9mL，從10到1850mL。術後平均住院時間為5.66±0.81天，與單側肺癌病人相似（5.67±0.19天，p=0.998）。沒有手術併發症或手術死亡。雙側同時原發性肺癌病人的總生存期與<1期單側肺癌病人的總生存期無顯著差異（p=0.285）。肺癌轉移另側肺病人的總生存率高於>2期的單側肺癌（p<0.001）。本研究的結論是同一次雙側胸腔鏡手術治療雙側肺癌手術風險少，總體生存率可接受。

並列關鍵字

胸腔鏡手術；同一次雙肺手術；雙側肺癌

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