• Clinics · Jan 2023

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

    • Paula Duarte D'Ambrosio, Alessandro Wasum Mariani, Eserval Rocha Júnior, de MedeirosIsrael LopesILHospital do Coração de Messejana, Fortaleza, CE, Brazil., Leonardo César Silva Oliveira, NetoAntero GomesAGHospital do Coração de Messejana, Fortaleza, CE, Brazil., Ricardo Mingarini Terra, and Paulo Manuel Pêgo-Fernandes.
    • Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (HCFMUSP), São Paulo, SP, Brazil. Electronic address: paula.dambrosio@hc.fm.usp.br.
    • Clinics (Sao Paulo). 2023 Jan 1; 78: 100169100169.

    ObjectiveIdentify the one-year survival rate and major complications in patients submitted to pneumonectomy for infectious disease.MethodsRetrospective 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.Results56 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).ConclusionsPneumonectomy 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.Copyright © 2023 HCFMUSP. Published by Elsevier España, S.L.U. All rights reserved.

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