SAFETY AND RISK FACTORS FOR THE MORBIDITY AND MORTALITY OF PNEUMONECTOMY: A RETROSPECTIVE 10- YEAR STUDY IN A SINGLE INSTITUTION

Authors

  • Joana Rei Cardiothoracic Surgery Department, Centro Hospitalar de Vila Nova de Gaia/Espinho-EPE, Vila Nova de Gaia, Portugal
  • Susana Lareiro Cardiothoracic Surgery Department, Centro Hospitalar de Vila Nova de Gaia/Espinho-EPE, Vila Nova de Gaia, Portugal
  • Pedro Fernandes Cardiothoracic Surgery Department, Centro Hospitalar de Vila Nova de Gaia/Espinho-EPE, Vila Nova de Gaia, Portugal
  • Patrícia Castro Cardiothoracic Surgery Department, Centro Hospitalar de Vila Nova de Gaia/Espinho-EPE, Vila Nova de Gaia, Portugal
  • Sara S. Costa Cardiothoracic Surgery Department, Centro Hospitalar de Vila Nova de Gaia/Espinho-EPE, Vila Nova de Gaia, Portugal
  • José Miranda Cardiothoracic Surgery Department, Centro Hospitalar de Vila Nova de Gaia/Espinho-EPE, Vila Nova de Gaia, Portugal
  • Luís Vouga Cardiothoracic Surgery Department, Centro Hospitalar de Vila Nova de Gaia/Espinho-EPE, Vila Nova de Gaia, Portugal
  • Miguel Guerra Cardiothoracic Surgery Department, Centro Hospitalar de Vila Nova de Gaia/Espinho-EPE, Vila Nova de Gaia, Portugal; Faculty of Medicine of the University of Porto, Oporto, Portugal

DOI:

https://doi.org/10.48729/pjctvs.32

Abstract

Objectives: Pneumonectomy is a procedure with high post-operative morbidity and mortality. This study aims to assess and identify possible risk factors that can affect post-operative outcome, therefore determining the safety of pneumonectomy in specific groups.

Methods: A total of 63 patients submitted to pneumonectomy at our centre, from February 2008 to February 2018, were included in our retrospective study. Age, gender, side of intervention, diagnosis, pre-operative symptoms, substance abuse and comorbidities were assessed. Early and late post-operative complications, as well as death were our major outcomes. We analysed the impact of preoperative variables on major outcomes using SPSS statistics.

Results: We found a 9,8% surgery-related mortality and 1-year survival rate of 76,2%. The incidence of early complications in our population was of 35% while eleven patients (17,4%) developed late post-operative complications. No statistical difference was found when comparing survival time between genders or age groups. Right sided pneumonectomies seem to be associated with an higher mortality risk. No other association between risk factors and outcomes reached statistical significance in both univariate and multivariate analysis.

Conclusions: Pneumonectomy is a viable option regardless of age whenever the patient has a good functional and cardiopulmonary status. Gender and diagnostic group do not seem to influence adverse event risk, although right- -sided pneumonectomies show an increased risk for post-operative death. Care should be taken with patients submitted to neoadjuvant therapy. All patients should be encouraged to cease smoking as early as possible before surgery, given the increased risks for post-operative complications.

Downloads

Download data is not yet available.

References

Deslauriers, J., et al., Long-term physiological consequences of pneumonectomy. Semin Thorac Cardiovasc Surg, 2011. 23(3): p. 196-202.

Bryant, A.S., R.J. Cerfolio, and D.J. Minnich, Survival and quality of life at least 1 year after pneumonectomy. J Thorac Cardiovasc Surg, 2012. 144(5): p. 1139-43.

James TW, F.L., Indications for pneumonectomy. Pneumonectomy for malignant disease. Ann Thorac Surg, 2011. (92): p. 244 –50

Mitsudomi, T., et al., Postoperative complications after pneumonectomy for treatment of lung cancer: multivariate analysis. J Surg Oncol, 1996. 61(3): p. 218-22.

Llewellyn-Bennett, R., R. Wotton, and D. West, Prophylactic flap coverage and the incidence of bronchopleural fistulae after pneumonectomy. Interact Cardiovasc Thorac Surg, 2013. 16(5): p. 681-5.

Kalathiya, R.J., D. Davenport, and S.P. Saha, Long-term survival after pneumonectomy for non-small-cell lung cancer. Asian Cardiovasc Thorac Ann, 2013. 21(5): p. 574-81.

Rivera, C., et al., Pneumonectomy for benign disease: indications and postoperative outcomes, a nationwide study. Eur J Cardiothorac Surg, 2015. 48(3): p. 435-40; discussion 440.

Kang, M.W., et al., Surgical treatment for multidrug-resistant and extensive drug-resistant tuberculosis. Ann Thorac Surg, 2010. 89(5): p. 1597-602.

Shapiro, M., et al., Predictors of major morbidity and mortality after pneumonectomy utilizing the Society for Thoracic Surgeons General Thoracic Surgery Database. Ann Thorac Surg, 2010. 90(3): p. 927-34; discussion 934-5.

Hu, X.F., et al., Risk factors for early postoperative complications after pneumonectomy for benign lung disease. Ann Thorac Surg, 2013. 95(6): p. 1899-904.

Qadri, S.S., et al., Short- and long-term outcomes of pneumonectomy in a tertiary center. Asian Cardiovasc Thorac Ann, 2016. 24(3): p. 250-6.

Leo, F., et al., The risk of pneumonectomy over the age of 70. A case-control study. Eur J Cardiothorac Surg, 2007. 31(5): p. 780-2.

van Meerbeeck, J.P., R.A.M. Damhuis, and M.L. Vos de Wael, High postoperative risk after pneumonectomy in elderly patients with right-sided lung cancer. European Respiratory Journal, 2002. 19(1): p. 141-145.

Dyszkiewicz, W., K. Pawlak, and L. Gasiorowski, Early post-pneumonectomy complications in the elderly. Eur J Cardiothorac

Surg, 2000. 17(3): p. 246-50.

Swartz, D.E., et al., Perioperative mortality after pneumonectomy: analysis of risk factors and review of the literature. Can J Surg, 1997. 40(6): p. 437-44.

Licker, M., et al., Risk factors for early mortality and major complications following pneumonectomy for non-small cell carcinoma of the lung. Chest, 2002. 121(6): p. 1890-7.

Ludwig, C., et al., Comparison of morbidity, 30-day mortality, and long-term survival after pneumonectomy and sleeve lobectomy for non-small cell lung carcinoma. Ann Thorac Surg, 2005. 79(3): p. 968-73.

Patel, R.L., E.R. Townsend, and S.W. Fountain, Elective pneumonectomy: factors associated with morbidity and operative mortality. Ann Thorac Surg, 1992. 54(1): p. 84-8.

Algar, F.J., et al., Predicting pulmonary complications after pneumonectomy for lung cancer. Eur J Cardiothorac Surg, 2003. 23(2): p. 201-8.

Annessi, V., et al., Is age over 70 years a risk factor for pneumonectomy? Asian Cardiovasc Thorac Ann, 2009. 17(3): p. 272-7.

Pagni, S., et al., Pulmonary resection for malignancy in the elderly: is age still a risk factor? Eur J Cardiothorac Surg, 1998. 14(1): p. 40-4; discussion 44-5.

Bolukbas, S., M.H. Eberlein, and J. Schirren, Pneumonectomy vs. sleeve resection for non-small cell lung carcinoma in the elderly: analysis of short-term and long-term results. Thorac Cardiovasc Surg, 2011. 59(3): p. 142-7.

Dell'Amore, A., et al., Early and long-term results of pulmonary resection for non-small-cell lung cancer in patients

over 75 years of age: a multi-institutional study. Interact Cardiovasc Thorac Surg, 2013. 16(3): p. 250-6.

Ginsberg, R.J., et al., Modern thirty-day operative mortality for surgical resections in lung cancer. J Thorac Cardiovasc Surg, 1983. 86(5): p. 654-8.

Fernandez, F.G., et al., Impact of laterality on early and late survival after pneumonectomy. Ann Thorac Surg, 2011. 92(1): p. 244-9.

Downloads

Published

17-04-2021

How to Cite

1.
Rei J, Lareiro S, Fernandes P, Castro P, Costa SS, Miranda J, Vouga L, Guerra M. SAFETY AND RISK FACTORS FOR THE MORBIDITY AND MORTALITY OF PNEUMONECTOMY: A RETROSPECTIVE 10- YEAR STUDY IN A SINGLE INSTITUTION. Rev Port Cir Cardiotorac Vasc [Internet]. 2021 Apr. 17 [cited 2024 Dec. 4];27(3):203-8. Available from: https://pjctvs.com/index.php/journal/article/view/32

Issue

Section

Original Articles

Most read articles by the same author(s)

1 2 3 4 > >>