Current morbimortality and one-year survival after pneumonectomy for infectious diseases

• Published in: Clinics (São Paulo, Brazil) Brazil), 2023-01, Vol.78, p.100169-100169, Article 100169
• Main Authors: D'Ambrosio, Paula Duarte, Mariani, Alessandro Wasum, Júnior, Eserval Rocha, de Medeiros, Israel Lopes, Oliveira, Leonardo César Silva, Neto, Antero Gomes, Terra, Ricardo Mingarini, Pêgo-Fernandes, Paulo Manuel
• Format: Article
• Language: English
• Subjects: Adult; Communicable Diseases - complications; Communicable Diseases - surgery; Female; Humans; Infectious disease; Lung Diseases - surgery; Male; MEDICINE, GENERAL & INTERNAL; mortality; Original; Pneumonectomy; Pneumonectomy - adverse effects; Pneumonectomy - methods; Postoperative Complications - etiology; Retrospective Studies; survival; Tuberculosis
• ISSN: 1807-5932; 1980-5322; 1980-5322
• DOI: 10.1016/j.clinsp.2023.100169

•Pneumonectomy for benign disease is a high-risk procedure performed for a variety of indications.•Patients with benign conditions would be expected to have superior long-term survival in comparison with those with malignancy.•Morbidity is often significant, with a meticulous operative technique and detailed patient management, which can be similar to a pneumonectomy performed for malignancy.•Pneumonectomy for a benign disease should continue to be considered a treatment option for carefully selected patients. Identify the one-year survival rate and major complications in patients submitted to pneumonectomy for infectious disease. Retrospective data from all cases of infectious disease pneumonectomy over the past 10 years were collected from two reference centers. The authors analyzed: patient demographics, etiology, laterality, bronchial stump treatment, presence of previous pulmonary resection, postoperative complications in the first 30 days, the treatment used in pleural complications, and one-year survival rate. 56 procedures were performed. The average age was 44 years, with female predominance (55%). 29 cases were operated on the left side (51%) and the most frequent etiology was post-tuberculosis (51.8%). The overall incidence of complications was 28.6% and the most common was empyema (19.2%). Among empyema cases, 36.3% required pleurostomy, 27.3% required pleuroscopy and 36.3% underwent thoracoplasty for treatment. Bronchial stump fistula was observed in 10.7% of cases. From all cases, 16.1% were completion pneumonectomies and 62.5% of these had some complication, a significantly higher incidence than patients without previous surgery (p = 0.0187). 30-day in-hospital mortality was (7.1%) with 52 cases (92.9%) and 1-year survival. The causes of death were massive postoperative bleeding (1 case) and sepsis (3 cases). Pneumonectomy for benign disease is a high-risk procedure performed for a variety of indications. While morbidity is often significant, once the perioperative risk has passed, the one-year survival rate can be very satisfying in selected patients with benign disease.