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Pneumonectomy after contralateral lobectomy: is it reasonable?
A K Vaaler1, H O Hosannah, R B Wagner
1National Naval Medical Center, Bethesda, Maryland.
The Annals of Thoracic Surgery
|January 1, 1995
Summary
Performing a left pneumonectomy after prior right lung resection for lung cancer is feasible. Patients with adequate pulmonary function can undergo this radical surgery with good outcomes.
Area of Science:
- Thoracic Surgery
- Pulmonary Medicine
- Oncology
Background:
- Metachronous primary lung cancers necessitate careful surgical planning.
- Conservative resection is preferred, but not always possible for second primary lung cancers.
Observation:
- Three patients underwent left pneumonectomy after previous right upper lobe resection for lung cancer.
- Pulmonary function tests and perfusion scans predicted adequate post-pneumonectomy lung function (FEV1 ≥ 1.00 L).
Findings:
- All three patients experienced uncomplicated postoperative courses.
- Follow-up at 2-6 months showed satisfactory condition in all patients.
- Two patients died within 8 months from unrelated causes or complications; one is alive at 15 months.
Implications:
- Pneumonectomy after contralateral lobectomy, though rare, can be a viable option for select lung cancer patients.
- Careful patient selection based on pulmonary function is crucial for successful outcomes.