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Robotic-assisted Left Pneumonectomy For Vanishing Lung Syndrome
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Traumatic pneumonectomy: a viable option for patients in extremis
Jill Halonen-Watras1, James O'Connor, Thomas Scalea
1R Adams Cowley Shock Trauma Center, University of Maryland Medical System, University of Maryland School of Medicine, Baltimore, Maryland 21201, USA
The American Surgeon
|June 18, 2011
Summary
Pneumonectomy after trauma is rare and carries a high mortality risk, especially for critically ill patients. This study found a 57% mortality rate, highlighting the need for intensive perioperative support.
Area of Science:
- Trauma Surgery
- Thoracic Surgery
- Critical Care Medicine
Background:
- Pneumonectomy following severe trauma is infrequently performed.
- High mortality rates are anticipated due to combined respiratory insufficiency, right heart failure, and shock.
Purpose of the Study:
- To review outcomes of patients requiring pneumonectomy after trauma.
- To identify factors influencing survival and complications in this high-risk group.
Main Methods:
- Retrospective review of seven patients undergoing pneumonectomy over six years.
- Data collection included demographics, injury severity, operative course, critical care management, and mortality.
Main Results:
- Mean age 26.5 years; 5 penetrating, 2 blunt trauma.
- High rates of right heart failure (100%), significant blood loss (5.4L), and need for advanced support (ventilation, RRT, ECMO).
- Mortality was 57%, with 42% survival for patients presenting in extremis.
Conclusions:
- Pneumonectomy in trauma patients is rare and associated with substantial mortality.
- Patients presenting in extremis require intensive intra- and postoperative support for survival.
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