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Indications for pneumonectomy. Pneumonectomy for benign disease

A A Conlan1, S E Kopec

  • 1Department of Surgery, University of Massachusetts Medical School, Worcester, USA.

Chest Surgery Clinics of North America
|June 12, 1999
PubMed

Insights

Pneumonectomy, lung removal surgery, can be complex for inflammatory diseases but offers excellent cures for infections like MDR-TB. Careful pre-operative management is crucial to minimize risks such as empyema and bronchopleural fistula.

Area of Science:

  • Thoracic Surgery
  • Pulmonology
  • Infectious Diseases

Background:

  • Pneumonectomy is necessary for various nonmalignant lung diseases.
  • Inflammatory lung conditions often lead to high morbidity, including empyema and bronchopleural fistula post-surgery.
  • Traumatic pneumonectomy carries a very high mortality rate.

Purpose of the Study:

  • To review the indications and outcomes of pneumonectomy for nonmalignant lung diseases.
  • To highlight the challenges and benefits of pneumonectomy in specific inflammatory conditions.
  • To emphasize risk mitigation strategies for pneumonectomy.

Main Methods:

  • Review of clinical literature and surgical outcomes for pneumonectomy.
  • Analysis of complication rates associated with pneumonectomy for different pathologies.
  • Evaluation of pre-operative management strategies to improve patient outcomes.

Main Results:

  • Pneumonectomy for inflammatory diseases, including multidrug-resistant tuberculosis (MDR-TB), MOTT infections, and fungal infections, demonstrates excellent cure rates.
  • High rates of post-pneumonectomy space empyema and bronchopleural fistula are associated with inflammatory lung disease.
  • Pneumonectomy for trauma is linked to extremely high mortality, necessitating avoidance when feasible.

Conclusions:

  • While challenging, pneumonectomy can be curative for specific inflammatory lung diseases with proper pre-operative preparation.
  • Minimizing sputum production, optimizing nutrition, and controlling infection pre-surgery are vital for reducing complications.
  • Pneumonectomy for trauma should be avoided due to prohibitive mortality risks.

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