[Completion pneumonectomy: indications, complications, and results]

Area of Science:

• Thoracic Surgery
• Pulmonary Medicine
• Surgical Outcomes

Background:

• Completion pneumonectomy is a complex procedure with known high morbidity and mortality.
• Outcomes are particularly concerning in patients with benign lung conditions.
• Limited literature exists comparing outcomes based on disease indication.

Purpose of the Study:

• To evaluate patient indications, complications, and postoperative results of completion pneumonectomy.
• To compare these outcomes with existing literature on standard pneumonectomy.
• To identify risk factors influencing morbidity and mortality.

Main Methods:

• Retrospective review of 27 consecutive patients undergoing completion pneumonectomy between 1987 and 2001.
• Analysis of indications (benign vs. malignant diseases) and associated complications.
• Calculation and comparison of postoperative morbidity and mortality rates.

Main Results:

• 23 of 27 patients (85.2%) underwent completion pneumonectomy for benign diseases (tuberculosis, bronchiectasis, etc.).
• Hospital mortality was 7.4%, with all deaths in the benign disease group.
• Complications occurred in 33.3% of patients, exclusively in those with benign indications, with bronchopleural fistula and empyema being most common.

Conclusions:

• Completion pneumonectomy can achieve acceptable outcomes in selected patients, comparable to standard pneumonectomy.
• However, complication risk is elevated in benign conditions, particularly tuberculosis.
• Meticulous surgical technique is crucial for minimizing severe complications like bronchopleural fistula and empyema.