ReviewFrontiers in surgery2025
One-stage vs. two-stage thoracoscopic surgery for synchronous bilateral pulmonary nodules: a systematic review and meta-analysis.
Review in Frontiers in surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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7 authors.
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Abstract
Introduction: The optimal surgical strategy for synchronous bilateral pulmonary nodules remains unclear. One-stage bilateral resections may offer logistical and clinical advantages, but safety concerns persist regarding bilateral complications. Methods: We conducted a systematic review and meta-analysis of studies comparing one-stage vs. two-stage pulmonary resections in adult patients with synchronous bilateral nodules. Ten observational studies were included, encompassing 1,015 patients. Continuous outcomes were assessed using mean differences (MDs) and binary outcomes with odds ratios (ORs), applying DerSimonian and Laird random-effects models. Subgroup and meta-regression analyses were performed. Statistical analyses were conducted using R software (v4.4.1). Results: One-stage resection was associated with significantly reduced operative time (MD -24.36 min; 95% CI -40.59 to -8.13), shorter hospital stay (MD -2.79 days; 95% CI -4.25 to -1.33), and lower direct surgical costs (MD -5,543.73 USD; 95% CI -6,601.05 to -4,486.40). No significant differences were observed in intraoperative blood loss, persistent air leak, or arrhythmia. Subgroup analysis revealed that the type of pulmonary lesion influenced hospital stay, while meta-regression showed no effect of lobectomy rate. Conclusions: One-stage bilateral resection demonstrates greater efficiency without increased morbidity, supporting its use in experienced centers. These findings suggest that a single-anesthetic approach may facilitate earlier recovery and timely systemic therapy in selected patients. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD420251048804, identifier: CRD420251048804.
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