Late complications of major thoracic surgery

Long-term consequences of major lung surgery were evaluated by: a prospective study of 206 pneumonectomy patients operated upon between 1947 and 1952 for tuberculosis; a retrospective study of 449 pneumonectomy patients operated upon between 1946 and 1974 for bronchial carcinoma at an age of 60 or over; a prospective study of 80 patients who underwent bilateral resection for bronchiectasis between 1940 and 1974. The main conclusions of these studies are: After pneumonectomy for non-malignant disease, life expectancy is slightly reduced in comparison with a matched group from the general population. Thoracoplasty and pneumonectomy proved less favorable. From the spirographic data the actual vital capacity (VC) showed the closest relation to life expectancy. In patients with bronchial carcinoma there was no relation between survival and the postoperative spirographic data. Preoperative and postoperative mortality was the same in the elderly as in the younger group of patients. Survival depended mainly on the malignancy itself. In bronchiectasis the results were good when a normal qualitative function was present. Unsatisfactory results were found in patients with chronic obstructive pulmonary disease. The VCs after surgery are well above the predicted values for the remaining segments. The presence from early youth on of non-functioning lung tissue, and its removal apparently result in a compensatory increase of the VC of the remaining segments. Life expectancy is good, even if the number of resected segments surpasses that of a right-sided pneumonectomy.