Risk factors for early postoperative complications after pneumonectomy for benign lung disease

Ann Thorac Surg. 2013 Jun;95(6):1899-904. doi: 10.1016/j.athoracsur.2013.03.051. Epub 2013 May 1.

Abstract

Background: Pneumonectomy is associated with a significant incidence of postoperative complications. The purpose of this study is to identify the risk factors associated with adverse outcomes.

Methods: One hundred thirty-six patients with benign lung disease who underwent pneumonectomy were included in this retrospective analysis. Postoperative complications were observed during the 30-day follow-up. Univariate and multivariate analysis was performed to investigate the risk factors of pneumonectomy among the patients.

Results: Postoperative complications were observed in 33 patients (24.26%). The rate of bronchopleural fistula was 6.1% (9 of 136). Five perioperative deaths (3.68%) were noted. Univariate analysis and multivariate analysis indicated that type of disease (hazard ratio [HR], 3.158; 95% confidence interval [CI], 1.248 to 7.992; p = 0.015) and operation duration (HR, 2.508; 95% CI, 1.035 to 6.080; p = 0.042) were independent risk factors of postoperative complications, and that type of disease (HR, 6.409; 95% CI, 1.669 to 6.021; p = 0.011) and pulmonary function (HR, 6.159; 95% CI, 0.018 to 0.625; p = 0.013) were independent risk factors of bronchopleural fistula for patients with benign lung disease after pneumonectomy.

Conclusions: A high incidence of complications was reported among patients with benign lung disease after pneumonectomy. The type of disease and operation duration were the best independent predictors of morbidity after this surgery. With careful patient selection and operative technique, morbidity and mortality rates could be comparable to those for pneumonectomy in cancer patients. Pneumonectomy is still a satisfactory treatment method for benign lung disease.

MeSH terms

  • Adult
  • Age Distribution
  • Aged
  • Analysis of Variance
  • Cohort Studies
  • Confidence Intervals
  • Female
  • Follow-Up Studies
  • Humans
  • Incidence
  • Lung Diseases / epidemiology
  • Lung Diseases / pathology*
  • Lung Diseases / surgery*
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Pneumonectomy / adverse effects
  • Pneumonectomy / methods*
  • Postoperative Complications / mortality
  • Postoperative Complications / physiopathology
  • Retrospective Studies
  • Risk Factors
  • Severity of Illness Index
  • Sex Distribution
  • Survival Rate
  • Time Factors
  • Treatment Outcome
  • Young Adult