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Clinical analysis of pneumonectomy for destroyed lung: a retrospective study of 32 patients

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Abstract

Objective

Destroyed lung is whole lung destruction secondary to chronic or recurrent lung infections. This clinical condition can result in irreversible changes in the lung parenchyma. In this study, we aimed to evaluate patients undergoing pneumonectomy with a diagnosis of lung destruction in terms of surgical technique, post-operative morbidity and mortality, and long-term outcomes.

Methods

A total of 32 patients that underwent pneumonectomy due to a destroyed lung between 2005 and 2017 were retrospectively reviewed. Age, gender, presenting symptoms, etiologies, localization of the destruction, pre-operative medical history, pre- and post-operative respiratory function tests, intraoperative complications and bleeding volume, morbidity and mortality, length of hospital stay, and long-term follow-up outcomes were reviewed for each patient.

Results

The study included 32 patients with a mean age of 31.7 ± 10.8 years. All the patients presented with persistent cough, whereas sputum production was presented by 25, hemoptysis by 18, and chest pain by 11 patients. The underlying primary diseases included nonspecific bronchiectasis in 20 (62.5%), tuberculosis in 9 (28.1%), left pulmonary hypoplasia accompanied by Bochdalek hernia in 2 (6.2%), and aspiration of a foreign body lodged in the left main bronchus in 1 (3.1%) patient. Mean operative time was 220.6 ± 40.2 min and mean perioperative bleeding was 450.9 ± 225.7 ml. Post-operative complications occurred in 14.2% of the patients, most commonly including atelectasis associated with stasis of secretions and wound site infection. Mean post-operative hospital stay was 11.8 ± 2.8 days and mean follow-up period was 35.5 ± 28.3 months. A significant clinical improvement was observed in 81.2% of the patients post-operatively.

Conclusions

Favorable long-term outcomes were obtained in our patients through careful patient selection and appropriate pre-operative work-up and surgical technique.

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References

  1. Aydın Y, Kaynar H, İntepe YS, Türkyılmaz A, Eroğlu A. Pneumonectomy in destroyed lung cases. Sakarya Med J. 2012;2(2):81–5.

    Article  Google Scholar 

  2. Stephen T, Thankachen R, Madhu AP, Neelakantan N, Shukla V, Korula RJ. Surgical results in bronchiectasis: analysis of 149 patients. Asian Cardiovasc Thorac Ann. 2007;15(4):290–6.

    Article  PubMed  Google Scholar 

  3. Kosar A, Orki A, Kiral H, Demirhan R, Arman B. Pneumonectomy in children for destroyed lung: evaluation of 18 cases. Ann Thorac Surg. 2010;89(1):226–31.

    Article  PubMed  Google Scholar 

  4. Yun-Fei WU. Hong Zhi-Peng. Surgical treatment of unilateral destroyed lung. Int J Surg. 2009;36(8):562–5.

    Google Scholar 

  5. Yuncu G, Ceylan KC, Sevinc S, Ucvet A, Kaya ŞÖ, Kiter G, et al. Functional results of surgical treatment of bronchiectasis in a developing country. Arch Bronconeumol. 2006;42(4):183–8.

    Article  CAS  PubMed  Google Scholar 

  6. Blyth DF. Pneumonectomy for inflammatory lung disease. Eur J Cardiothorac Surg. 2000;18(4):429–34.

    Article  CAS  PubMed  Google Scholar 

  7. Bai L, Hong Z, Gong C, Yan D, Liang Z. Surgical treatment efficacy in 172 cases of tuberculosis-destroyed lungs. Eur J Cardiothorac Surg. 2012;41(2):335–40.

    Article  PubMed  Google Scholar 

  8. Halezaroğlu S, Keleş M, Uysal A, Celik M, Senol C, Hacıibrahimoglu G, et al. Factors affecting postoperative morbidity and mortality in destroyed lung. Ann Thorac Surg. 1997;64:1635–8.

    Article  Google Scholar 

  9. Kosasih KA, Amin Z, Amanda AP. Mortality rate of patient with tuberculosis-destroyed lung. Ina J Chest Crit Emerg Med. 2016;3(2):80–5.

    Google Scholar 

  10. Eren Ş, Eren MN, Balcı AE. Pneumonectomy in children for destroyed lung and the long term consequences. The J Thorac Cardvasc Surg. 2003;126(2):574–81.

    Article  Google Scholar 

  11. Conlan AA, Scott EK. Pneumonectomy for benign disease. In: Deslauries J, Faber LP, editors. Chest surgery clinics of North America. Philadelphia: Saunders; 1999. p. 311–25.

    Google Scholar 

  12. Miller JI. Bacterial infections of the lungs and bronchial compressive disorders Shields. In: Thomas W, editor. General thoracic surgery. 5th ed. Philadelphia: Lippincott Williams & Wilkins; 2000. p. 1048–51.

    Google Scholar 

  13. Ashour M, Pandya L, Mezraqji A, Qutashat W, Desouki M, Sharif NA, et al. Unilateral post-tuberculous lung destruction: the left bronchus syndrome. Thorax. 1990;45:210–212.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Hewitson JP, Oppell UOV. Role of thoracic surgery for childhood tuberculosis. World J Surg. 1997;21:468–74.

    Article  CAS  PubMed  Google Scholar 

  15. Conlan AA, Lukanich JM, Shutz J, Hurwitz SS. Elective pneumonectomy for bening lung disease: modern-day mortality and morbidity. J Thorac Cardiovasc Surg. 1995;110:1118–24.

    Article  CAS  PubMed  Google Scholar 

  16. Massard G, Dabbagh A, Wihlm JM, Kessler R, Barsotti P, Roeslin N, et al. Pneumonectomy for chronic infection is a high-risk procedure. Ann Thorac Surg. 1996;62:1033–8.

    Article  CAS  PubMed  Google Scholar 

  17. Shiraishi Y, Nakajiama Y, Koyama A, Takasuna K, Yoshida S. Morbidity and mortality after 94 extrapleural pneumonectomies for empyema. Ann Thorac Surg. 2000;70:1202–6.

    Article  CAS  PubMed  Google Scholar 

  18. Singh B, Chaudhary O. Trends of pulmonary impairment in persons with treated pulmonary tuberculosis. Int J Med Res. 2015;1(1):8–11.

    Google Scholar 

  19. Novoa N, Varela G, Jimenez MF, Aranda JL. Influence of major pulmonary resection on postoperative daily ambulatory activity of the patients. Interact Cardiovasc Thorac Surg. 2009;9:934–8.

    Article  PubMed  Google Scholar 

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FS, IO and UÇ participated in conception and design. AŞ participated in data analysis and interpretion. FS and IO participated in manuscript writing.

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Correspondence to Ilhan Ocakcioglu.

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Sayir, F., Ocakcioglu, I., Şehitoğulları, A. et al. Clinical analysis of pneumonectomy for destroyed lung: a retrospective study of 32 patients. Gen Thorac Cardiovasc Surg 67, 530–536 (2019). https://doi.org/10.1007/s11748-018-01055-6

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