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Ann Thorac Surg 1988;45:62-65
© 1988 The Society of Thoracic Surgeons

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Articles

Bilobectomy for Bronchogenic Carcinoma

From the Division of Thoracic Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY

Accepted for publication August 25, 1987.

^* Address reprint requests to Dr. Keller, Department of Surgical Oncology, The Fox Chase Cancer Ctr, 7701 Burholme Ave, Philadelphia, PA 19111

During a 12-year period, bilobectomy was performed on 166 patients for the treatment of primary lung carcinoma: 108 patients (65%) underwent right upper and middle lobectomy, while 58 patients (35%) underwent right middle and lower lobectomy. Indications for bilobectomy were tumor extending across a fissure (45%), absent fissure (21%), endobronchial tumor (14%), extrinsic tumor or nodal invasion of bronchus intermedius (10%), and vascular invasion (5%). Thirty-one patients (19%) suffered 41 perioperative complications, and 7 patients (4.2%) died. Upper and middle lobectomies were not associated with a significantly different morbidity (p > 0.10) or mortality (p > 0.10) when compared with middle and lower lobectomy. The postoperative chest roentgenograms of all patients demonstrated ipsilateral volume loss, and 31 patients were found to have asymptomatic hydropneumothoraces, which cleared during the follow-up period. Late complications occurred in 4 patients (2%) and included two empyemas, one bronchopleural fistula, and one superficial wound infection. These results indicate that bilobectomy is associated with morbidity and mortality that lie between those currently reported for lobectomy and pneumonectomy.

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