Pneumonectomy for chronic infection is a high-risk procedure.
BACKGROUND
The purpose of this study was to estimate operative risk, and to identify indicators of adverse prognosis, in patients undergoing pneumonectomy for chronic infection.


METHODS
Twenty-five patients aged 41 +/- 15 years underwent pneumonectomy (three completions) for chronic infection: sequelae of tuberculosis, 15; cystic bronchiectasis, 9; and radiation pneumonitis, 1. Eight patients had aspergilloma (7 after tuberculosis, 1 with radiation pneumonitis).


RESULTS
Operative mortality was 4%. Operative blood loss was estimated at 1,983 +/- 1,424 mL, ranging from 150 to 5,600 mL. A single patient required reexploration. Eight patients (32%) had empyema, and a further 3 (12%) had bronchopleural fistula; thoracoplasty was required for 10 (40%). Sequelae of tuberculosis heralded increased operative bleeding (t = 2.884; p < 0.005). Incidence of empyema or bronchopleural fistula was increased in patients with sequelae of tuberculosis (chi 2 = 3.896; p < 0.05), patients with aspergilloma (chi 2 = 4.588; p < 0.05), patients in whom the parenchymal cavities were entered (chi 2 = 11.5; p < 0.001), and those in whom blood loss was in excess of 1,000 mL (chi 2 = 4.911; p < 0.05).


CONCLUSIONS
We conclude that pneumonectomy is a high-risk procedure, especially in patients with sequelae of tuberculosis.
Massard
G
G
Department of Thoracic Surgery, University Hospital of Strasbourg, France.
Dabbagh
A
A
Wihlm
J M
JM
Kessler
R
R
Barsotti
P
P
Roeslin
N
N
Morand
G
G
D000293:Adolescent; D000328:Adult; D000368:Aged; D001983:Bronchial Fistula / Q000209:etiology; D002648:Child; D002908:Chronic Disease; D016724:Empyema, Pleural / Q000209:etiology / Q000601:surgery; D005260:Female; D005402:Fistula / Q000601:surgery; D006801:Humans; D008172:Lung Diseases, Fungal / Q000150:complications / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010995:Pleural Diseases / Q000209:etiology / Q000601:surgery; D011013:Pneumonectomy / Q000009:adverse effects*; D011183:Postoperative Complications; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D014397:Tuberculosis, Pulmonary / Q000150:complications / Q000601:surgery*