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Folgen der Pneumonektomie in der Früh- und Spätphase

Consequences of pneumonectomy in the early and late phases

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Zusammenfassung

Die Pneumonektomie kann bei fortgeschrittenem oder zentral lokalisiertem nichtkleinzelligem Bronchialkarzinom die geeignete chirurgische Therapieoption darstellen. Eine onkologisch zufriedenstellende Tumorchirurgie ist in diesen Fällen zwar zu erreichen, jedoch ist die Pneumonektomie mit einer deutlich höheren Mortalität und Morbidität als parenchymsparende Resektionen der Lunge assoziiert.

Ziel dieser Übersichtsarbeit war die systematische Zusammenfassung und Darstellung der möglichen postoperativen Folgen einer Pneumonektomie in der Früh- und Spätphase, welche nicht nur von der Grunderkrankung abhängen, sondern vor allem durch den Zustand und die Funktion des verbleibenden kontralateralen Lungenparenchyms beeinflusst werden. Vor allem kardiopulmonale Komplikationen wie Pneumonie, Lungenembolie, Herzrhythmusstörungen oder Myokardinfarkt führen in der frühen postoperativen Phase zu einer erhöhten 30-Tage-Mortalität. Des Weiteren gilt das Patientenalter über 70 Jahre als ein signifikanter Risikofaktor für eine reduzierte Lebensqualität nach Pneumonektomie.

Abstract

Pneumonectomy can represent the appropriate surgical treatment option in advanced or centrally localized non-small cell lung cancer (NSCLC). A satisfactory oncologic tumor surgery can be reached in these cases although pneumonectomy is associated with a significantly higher mortality and morbidity than less extensive resection of the lung parenchyma.

The aim of this article is a systematic review and the presentation of possible postoperative consequences of pneumonectomy in the early and late phases, which depend not only on the underlying disease but are also primarily affected by the state and function of the remaining contralateral lung parenchyma. Cardiopulmonary complications, especially pneumonia, pulmonary embolism, cardiac arrhythmia or myocardial infarction lead to increased 30-day mortality in the early postoperative period. Moreover, advanced ages over 70 years can be identified as a significant risk factor for poor quality of life after pneumonectomy.

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  1. Thoraxchirurgischen Zentrums München, Klinik für Thoraxchirurgie der Lungenfachkliniken Gauting, Lungenfachkliniken Gauting/ Klinikum der Universität München, Robert-Koch-Allee 2, 82131, München-Gauting, Deutschland

    R.A. Hatz & L.V. Klotz

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  1. R.A. Hatz
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  2. L.V. Klotz
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Correspondence to R.A. Hatz.

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Hatz, R., Klotz, L. Folgen der Pneumonektomie in der Früh- und Spätphase. Chirurg 84, 497–501 (2013). https://doi.org/10.1007/s00104-012-2434-3

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  • DOI: https://doi.org/10.1007/s00104-012-2434-3

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