Are bilobectomies acceptable procedures?

Ann Thorac Surg. 1995 Sep;60(3):640-5. doi: 10.1016/0003-4975(95)00470-6.


Background: Controversy about operative morbidity and oncologic value of bilobectomy has led to a review of our experience over the past 12 years.

Methods: The charts of 112 patients (100 men and 12 women with a mean age of 63 years) were reviewed for operative mortality and morbidity and long-term survival. Survival of patients with stage I or stage II disease was compared with that of stage-matched and age-matched groups having right pneumonectomy.

Results: Four patients (3.5%) died postoperatively. Nonfatal complications occurred in 55 patients (49%); the most frequent problem was pleural space disease (34%). Survival studies focused on the 96 patients with nonsmall cell bronchogenic cancer (44 in stage I, 32 in stage II, and 20 in stage IIIA). The overall 5-year survival rate was 40%; the 5-year survival rate was similar for stage I and stage II (41% for stage I, 50% for stage II, and 17% for stage IIIA). The incidence of local recurrence was significantly increased after bilobectomy for stage I cancer (chi 2 = 5.066; p < 0.05) compared with pneumonectomy but did not affect 5-year survival. Local recurrence and survival were similar after bilobectomy and pneumonectomy in stage II.

Conclusions: These data demonstrate an increased morbidity after bilobectomy. Survival studies demonstrate an increased risk of local recurrence in patients with stage I disease, which might be partly explained by understaging.

Publication types

  • Comparative Study

MeSH terms

  • Adenocarcinoma / pathology
  • Adenocarcinoma / surgery
  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Bronchogenic / pathology
  • Carcinoma, Bronchogenic / surgery
  • Carcinoma, Non-Small-Cell Lung / pathology
  • Carcinoma, Non-Small-Cell Lung / surgery
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / surgery
  • Case-Control Studies
  • Female
  • Follow-Up Studies
  • Humans
  • Incidence
  • Lung Neoplasms / pathology
  • Lung Neoplasms / surgery*
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local
  • Neoplasm Staging
  • Pleural Diseases / etiology
  • Pneumonectomy / adverse effects
  • Pneumonectomy / methods*
  • Retrospective Studies
  • Risk Factors
  • Survival Rate
  • Treatment Outcome