Pneumonectomy For Inflammatory Lung Disease: Indications And Complications

Objective: Inflammatory lung disease (ILD) has been recognized as a growing health problem for human being. Despite it is great advances in the medical treatment of lung infections and intensive patients'caring,but it still remain difficult to treat with antimicrobial treatment at all. Patients whose disease is localized to one lung and who have sufficient cardiopulmonary reserve to tolerate resection are considered for pulmonary resection performed. Pneumonectomy is favored over less aggressive procedures when an entire lung is affected. Here we use a retrospective cohort study to reviews our experience in using pneumonectomy to treat patients with inflammatory lung disease (ILD).Methods: Between 1980 and 2004, 47 patients with ILD in Lung Disease Center of Laval University and Firsr Hospital of Jilin University received pneumonectomy, and all patients'HIV-test was negative.Of these 47 patients,22 were males (46.8﹪), 25 were females (53.2﹪), ranging from 16~78 years, (median, 56.8years). 36 (76.6﹪) patients underwent selective operation and 11 (23.4﹪) underwent emergency operation for massive hemoptysis. 24 (51.1﹪) patients had or had had tuberculosis at time of surgery,and the other ILD was 23 (49.9﹪). Thirty eight patients were followed range from 2-204 months. 9 patients were lost.Results: Morbidity was 18(38.2%), one (2.1%) was during the operation and 17 (36.2%)were during the thirty days after surgery. The main morbidity included bleeding five (10.6%), empyema one (2.1%) and broncho-pleural fistula four (8.5%). Mortality was 14.9 %, one (2.1%) died during the operation, five (10.6%) died in the early 30 days after surgery and one (2.1%) died in the late time (30-90 days after surgery). Of these patients there was one patients received left side pneumonectomy and right side were six .The selective operation mortility was 8.3% (3/36) and the emergency group was 36.7% (4/11). The actuarial 12- and 24- and 60-month survial rates were 83%, 80%, 69.6%.Conclusion: In spite of high mortality and complication after pneumonectomy, it is acceptable of the mortality and morbidity of operation for ILD. Pneumonectomy played important clinic role at saving the life of massive hemoptysis and objectivly promote the quality of patients'life.