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Published on: May 26, 2023
Evaluation of factors affecting morbidity and mortality in pneumonectomy patients
Mustafa Vedat Dogru1, Celal Buğra Sezen1, Cemal Aker1
1Department of Thoracic Surgery, Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey.
Background:
The aim of this study was to evaluate risk factors associated with morbidity and mortality after pneumonectomy in non-small cell lung cancer patients.
Methods:
The study included 107 patients who underwent pneumonectomy for non-small cell lung cancer between January 2013 and December 2018. Prognostic factors affecting mortality and morbidity were investigated.
Results:
The patient group included 10 women (9.3%) and 97 men (90.7%) with a mean age of 59.5 ± 8.5 years. Seventy-three patients (68.2%) underwent standard pneumonectomy and 34 (31.8%) underwent extended pneumonectomy. Nine patients (8.4%) received induction chemotherapy. Complications occurred in 33 patients (30.8%). Complications were classified as surgical, cardiovascular, pulmonary, or infectious. Charlson Comorbidity Index (CCI) > 3 and right-side resection were significant risk factors for the development of complications. The most common complication was atrial fibrillation. Eleven patients developed a bronchopleural fistula. The 30-day postoperative mortality rate was 6.5% (n = 7). Mortality was not associated with any demographic and surgical characteristics other than CCI > 3 (p = .05).
Conclusion:
The results of this study indicate that our pneumonectomy outcomes are acceptable despite high morbidity and mortality rates. Appropriate patient selection for pneumonectomy is as important as complication management. High-comorbidity patients should undergo these procedures in experienced centers.
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