Pneumonectomy: Indications and results

Abstract

Aim: In thoracic surgery, pneumonectomy operations are associated with high morbidity and mortality. In the present study, we assumed to determine operative indications and to overview the surgical treatment results.

Material and method: Present study includes the 72-pneumonectomized patients between January 2003 and December 2004. All patients were assessed on indication, patient characteristic, operative mortality and postoperative complication.

Results: The study population consists of 72 patients; 68 male (94.4%) and 4 (5.6%) female. Mean age was 56.8 +/- 11.0 years (range 20 to 77). Clinical diagnosis included 65 lung cancer (90.3%), 3 aspergilloma (4,1%), 2 bronchiectasis (2.8%), 1 endobronchial hamartoma (1,4%) and tuberculosis (1,4%). Sixteen of them (22.2%) have underwent neoadjuvant therapy previously. Additional chest wall resection was performed to 3 patients (4.2%). In 3 patients intrapericardial pneumonectomy were necessitated. Operative mortality rate was 6.9% (5 patient). Thirteen patients (18.1%) had complication, 4 suffered from arrhythmia, 4 from respiratory insufficiency, 4 from empyema, 2 from bronchopleural fistula, 2 from vocal cord paralysis, 2 from emboli, 2 from cardiac failure, 1 from pneumothorax, 1 from esophageal rupture, 1 from pulmonary edema and 1 from renal failure. Age over 60 (p=0.01), neoadjuvant therapy (p=0.03), comorbid disease (p=0.0008) and extended resections (p=0.008) are associated with increased complication rates. Operative mortality was found statistically higher in patients over 60 years of age (p=0.014), with comorbid disease (p=0.0004) and in patients whom extended resection was performed (p=0.05).

Conclusion: In the present study independent variables that affect on complications were age, extended resection, comorbid disease and neoadjuvant therapy. Age, comorbid disease and extended resection were associated with increased operative mortality.