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Indications, risks, and results of completion pneumonectomy
J Grégoire1, J Deslauriers, L Guojin
1Division of Thoracic Surgery, Le Centre de Pneumologie de Laval, Sainte-Foy, Quebec, Canada.
Summary
Completion pneumonectomy, a rare lung surgery, can be performed with risks comparable to standard pneumonectomy. This procedure offers a reasonable chance of long-term survival for patients with lung cancer or benign lung disease.
Area of Science:
- Thoracic Surgery
- Pulmonary Medicine
- Surgical Oncology
Background:
- Completion pneumonectomy involves removing remaining lung tissue after a prior partial resection.
- This procedure is infrequently indicated and historically associated with higher risks than standard pneumonectomy.
Purpose of the Study:
- To evaluate the operative risk and long-term survival outcomes of completion pneumonectomy.
- To compare outcomes between patients with malignant and benign lung diseases.
Main Methods:
- A retrospective review of 60 patients (aged 17-70) who underwent completion pneumonectomy over 20 years.
- Patients had diagnoses including recurrent lung cancer, new primary lung cancer, or benign pleuropulmonary disease.
- Standardized surgical techniques were employed, including bronchial division first and bronchial reinforcement.
Main Results:
- Overall operative mortality was 10% (6 deaths), higher in cancer patients (11.6%) than benign disease patients (5.9%).
- Actuarial 5-year survival rates were 48% overall, 33% for cancer, and 88% for benign disease.
- The operative risk was found to be similar to that of standard pneumonectomy.
Conclusions:
- Completion pneumonectomy can be performed with an acceptable operative risk, comparable to standard pneumonectomy.
- Patients undergoing this procedure have a reasonable prognosis for long-term survival, particularly those with benign conditions.