Article

Factors related to outcome after pneumonectomy: retrospective study of 62 patients.

Department of Surgery, St. Joseph Hospital, Veldhoven, The Netherlands.
The European Journal of Surgery 04/1999; 165(3):193-7. DOI: 10.1080/110241599750007036
Source: PubMed

ABSTRACT To find out which risk factors affect outcome after pneumonectomy.
Retrospective study.
Teaching hospital, The Netherlands.
62 patients who were treated for bronchial cancer by pneumonectomy between 1984 and 1995.
Hospital mortality and postoperative complications.
Hospital mortality increased with age, being 5/51 (10%) in the 40-69 age group and 4/11 (36%) in patients aged 70 or more. In the American Society of Anesthesiologists (ASA) class I group hospital mortality was 8% (2/26), in class II 12% (3/26) and in class III 40% (4/10). Hospital mortality was highest when the FEV1:FVC-ratio was below 55%. Cardiac arrhythmias developed in 8 (13%), early bronchopleural fistulas in 7 (11%), and postpneumonectomy syndrome in 5 (8%). These major complications had a high mortality.
Respiratory function, ASA class, and age over 70 years are the main prognostic factors for hospital morbidity and mortality after pneumonectomy.

0 Bookmarks
 · 
55 Views
  • [Show abstract] [Hide abstract]
    ABSTRACT: The purpose of this study was to investigate the morbidity and mortality of 100 consecutive patients with pneumonectomy for non-small cell lung cancer at the University of Kentucky. We retrospectively reviewed the medical records of 100 consecutive pneumonectomy patients, 1998-2009. The median age of patients was 59 years, with a range of 27 to 79 years. Sixty-eight patients (68%) were men. Fifty-four patients (54%) received left pneumonectomy. Major postoperative complication rate was 39%, with atrial fibrillation being the most common complication, occurring in 26 patients. The overall postoperative mortality rate was 11% (11/100 patients). The mortality rate among right pneumonectomy patients was 17.4% (8/46 patients) compared with 5.6% (3/54 patients) for left pneumonectomy. The postoperative mortality rate among patients receiving neoadjuvant therapy was 14.3% (4/28 patients). In addition, among patients who received neoadjuvant therapy, the mortality rate for right and left pneumonectomy was 21.4% (3/14 patients) and 7.1% (1/14 patients), respectively. The mortality rate among patients older than 70 years at the time of pneumonectomy was 18.2% (2/11 patients). With a postoperative mortality rate of 11% and a major postoperative complication rate of 39%, pneumonectomy for non-small cell lung cancer is associated with high morbidity and mortality. The factors associated with the increased mortality rate include right pneumonectomy, patient age older than 70 years at the time of procedure, and neoadjuvant therapy before pneumonectomy.
    Southern medical journal 07/2012; 105(7):350-4. · 0.92 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The comparison of the histologic healing and bronchopleural fistula (BPF) complications encountered with three different BS closure techniques (manual suture, stapler and manual suture plus tissue flab) after pneumonectomy in dogs was investigated for a one-month period. The dogs were separated into two groups: group I (GI) (n = 9) and group II (GII) (n = 9). Right and left pneumonectomies were performed on the animals in GI and GII, respectively. Each group was further divided into three subgroups according to BS closure technique: subgroup I (SGI) (n = 3), manual suture; subgroup II (SGII) (n = 3), stapler; and subgroup III (SGIII) (n = 3), manual suture plus tissue flab. The dogs were sacrificed after one month of observation, and the bronchial stumps were removed for histological examination. The complications observed during a one-month period following pneumonectomy in nine dogs (n = 9) were: BPF (n = 5), peri-operative cardiac arrest (n = 1), post-operative respiratory arrest (n = 1), post-operative cardiac failure (n = 1) and cardio-pulmonary failure (n = 1). Histological healing was classified as complete or incomplete healing. Histological healing and BPF complications in the subgroups were analyzed statistically. There was no significant difference in histological healing between SGI and SGIII (p = 1.00; p > 0.05), nor between SGII and SGIII (p = 1.00; p > 0.05). Similarly, no significant difference was observed between the subgroups in terms of BPF (p = 0.945; p > 0.05). The results of the statistical analysis indicated that manual suture, stapler or manual suture plus tissue flab could be alternative methods for BS closure following pneumonectomy in dogs.
    Journal of Veterinary Science 12/2007; 8(4):393-9. · 0.93 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The negative pressure realized into the hemi thorax with lung pneumonectomy has consequences upon the mediastinum organ statics. This aspect results in expansion of the other lung. These changes are usual but limited in the adult lung pneumonectomy. In the right lung pneumonectomy, the mediastinum moves to the operated part and disturbs the function of the vessels and cavities with thin wall or low pressure (vena cava, right atrium). These aspects are not described in the left lung pneumonectomy. Taking into consideration the previous factors, we present a particular case of a young woman with right lung pneumonectomy; this intervention was made in childhood, at ten years of age. After sixteen years of evolution it was realized a real mediastinum reshuffle, the heart was moved in the right hemi thorax, with dextrocardia-like aspect. This case is interesting because it involves the positive and differential diagnosis problems--dextrocardia, associated disorders, real complications.
    Interactive Cardiovascular and Thoracic Surgery 09/2006; 5(4):517-8. · 1.11 Impact Factor