Is Bilateral Pulmonary Lobectomy Feasible in Patients with Bilateral Lung Cancers?
Is Bilateral Pulmonary Lobectomy Feasible in Patients with Bilateral Lung Cancers?
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DOI：
10.1055/s-0034-1383816
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发表时间：
2015-10-01
影响因子：
1.5
通讯作者：
Oh, Shiaki
中科院分区：
文献类型：
--
作者：
Hattori, Aritoshi;Suzuki, Kenji;Oh, Shiaki
背景：虽然积极手术切除是治疗双侧肺癌的一种可接受的策略，但在双侧肺叶切除的适应证方面仍存在一些争议。双侧肺叶切除术后并发症的定义基于美国国家癌症研究所的不良事件通用术语标准版本4.0。结果在本研究中，21例患者接受了双侧肺癌分期手术的双侧肺叶切除。13例(62%)在二次手术后痊愈，无并发症发生。术后并发症8例(38%)，其中4例1~2级并发症较轻。右下叶切除、年龄70岁或肿瘤体积较大者术后并发症发生率较高(p=0.0041、0.0195、0.0324)。第二次手术后平均住院天数为8.0天。有5名患者住院死亡，其中3人死于呼吸衰竭。所有患者的中位随访期为40个月。双侧肺叶切除术后5年生存率为61.7%。结论双侧肺叶切除术是治疗双侧肺癌的一种可行的术式，选择合适的患者和周围术式是必要的。
Background While aggressive surgical resection is an acceptable strategy for bilateral lung cancers, there are still some controversies regarding the appropriate indications of bilateral pulmonary lobectomy.Methods Between 1996 and 2012, 21 patients underwent bilateral pulmonary lobectomy for bilateral lung cancers. Postoperative complications after bilateral pulmonary lobectomy were defined based on the Common Terminology Criteria for Adverse Event Version 4.0 (National Cancer Institute, USA).Results In this study, 21 patients underwent bilateral pulmonary lobectomy by staged surgery for bilateral lung cancers. Thirteen patients (62%) recovered without any complications after the second surgery. Among the eight (38%) patients with postoperative complications, four had relatively minor complications of grade 1 or 2. In contrast, postoperative complications were frequently observed in patients who underwent right lower lobectomy, were age >= 70 years, or had larger tumor size (p = 0.0041, 0.0195, 0.0324). The mean hospital stay after the second surgery was 8.0 days. In-hospital mortality was found in five patients including three of respiratory failure. The median follow-up period for all patients was 40 months. The 5-year survival rate after bilateral pulmonary lobectomy was 61.7%.Conclusion Although appropriate patient selection and careful perioperative management are mandatory, bilateral pulmonary lobectomy could be an acceptable procedure for patients with bilateral lung cancers.