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Trauma pneumonectomy: A narrative review.

B Phillips1, L Turco2, M Mirzaie3

  • 1Department of Surgery, Creighton University School of Medicine, Omaha, NE, United States; Department of Clinical Science and Translational Research, Creighton University School of Medicine, Omaha, NE, United States.

International Journal of Surgery (London, England)
|September 3, 2017
PubMed
Summary

Trauma pneumonectomy (TP) is a rare but justified procedure for severe thoracic injuries with ongoing hemorrhage. Despite high mortality, TP can be life-saving in select cases.

Keywords:
Pulmonary traumaPulmonectomyThoracic traumaTrauma pneumonectomy

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Area of Science:

  • Trauma Surgery
  • Thoracic Surgery
  • Pulmonary Medicine

Background:

  • Thoracic injuries are frequent in trauma patients.
  • Most thoracic injuries are managed non-operatively, but 7-20% require thoracotomy.
  • Pulmonary resection is needed in 1-6% of thoracotomies, with limited data on total pneumonectomy.

Purpose of the Study:

  • To review the current evidence for trauma pneumonectomy (TP).
  • To assess the justification of TP in selective cases despite its risks.
  • To highlight the importance of damage control techniques in TP.

Main Methods:

  • A comprehensive literature review was performed.
  • Studies included adult patients (age >15) with blunt or penetrating lung trauma.
  • Data on mortality and outcomes were extracted.

Main Results:

  • 14 studies with relevant data on TP were identified from 713 initial searches.
  • Studies spanned publications from 1985-2017, with data collected from 1972-2014.
  • Mortality rates for TP ranged from 50% to 100%, with a median of 63%.

Conclusions:

  • Pulmonary resection, including TP, may be necessary for severe thoracic trauma.
  • TP is indicated in cases of ongoing hemorrhage where less invasive methods fail.
  • Damage control thoracic surgery is crucial for improving outcomes in TP.