Full Text:

 

Ǵм Vol.24_No.2 Suppl. P.S304-309, Dec. 2007

Original Article

ϰ ȯ ־

Comparison of Postoperative Results after Pneumonectomy between Lung Cancer and Infectious Lung Disease Groups

, ö
б ǰ οܰб
åڣö, 뱸 5 317-1, б ǰ οܰб
Tel: (053) 620-3882, Fax: (053) 626-8660
E-mail: jclee@med.yu..ac.kr

December 30, 2007

Abstract

BackgroundPneumonectomy has been known with higher rate of morbidity and mortality. Thereby, we evaluated patients who received pneumonectomy for lung cancer and infectious lung disease related to postoperative morbidity and mortality. Materials and methodsThe retrospective study was undertaken in 55 patients who had undergone pneumonectomy at Yeungnam University Hospital from January 1996 to December 2004. We devided into two groups, lung cancer group (group A, n=40) and infectious lung disease group (group B, n=15) and then compared and analyzed. ResultsThe mean age was higher in group A and there was statistical significance (60.89.4 vs 45.712.1, p<0.001). With preoperative pulmonary function test, FEV1, FVC were higher in group A and there were statistical significane (p<0.001, p=0.006). With preoperative lung perfusion scan, the perfusion ratio of affected lung and postoperative predicted FEV1 were higher in group A and there were statistical significance (p<0.001, p=0.007). According to MRC dyspnea scale, change of respiratory difficulty of group A had statistical significance (p<0.001). There were a total 20 postoperative complications (36.4%) of which arrhythmia 7, postoperative bleeding 5, empyema and/or bronchopleural fistula 3, pneumonia 2, adult respiratory distress syndrome 1, vocal cord palsy 1. The postoperative complication rate was no difference between two groups (37.5% vs 33.3%) but arrhythmia developed in group A only. There were 3 postoperative mortalities, all in group A. ConclusionPreoperative pulmonary function test and postoperative predicted FEV1 were lower in group B, however, postoperative complication rate was no difference between two groups and mortality developed in group A only. Because of lesser resected lung volume and well adopted in long term diseased period, there was lesser hemodynamic change in infectious lung disease. So postoperative mortality not developed in infectious lung disease group due to arrhythmia and respiratory failure.

Key Words: Pneumonectomy, Cancer, Inflammatory lung disease

References

1. Ginsberg RJ, Hill LD, Eagan RT, Thomas P, Mountain CF, Deslauriers J et al. Modern thirty-day operation mortality for surgical resection in lung cancer. J Thorac Cardiovasc Surg 1983 Nov;86(5):654-8.

2. Huh GB, Cho SR, Kim SH, Ha HC, Park SD, Lee JS et al. Analysis of postpneumonectomy complications. Korean J Thorac Cardiovasc Surg 1993 Aug;26(8):613-9.

3. Chung KY, Hong KP, Lee JG, Kang KH, Kang MS. Prognostic factors affecting postoperative morbidity and mortality in destroyed lung. Korean J Thorac Cardiovasc Surg 2002 Mar; 35(5):387-91.

4. Francisco JA, Antonio A, Angel S, Baamonde C, Aranda JL, Lopez FJ. Predicting pulmonary complications after pneumonectomy for lung cancer. Eur J Cardiothorac Surg 2003 Feb;23 (2):201-8.

5. Chung KY, Kim KD. Assessment of operative risks of pneumonectomy. Korean J Thorac Cardiovasc Surg 1995 May;28(5):464-70.

6. Choi PJ, Woo JS. Factors affecting postoperative complication in pneumonectomy for chronic complicated inflammatory lung disease. Korean J Thorac Cardiovasc Surg 2000 Jan;33(1):73-8.

7. Patel RL, Townsend ER, Fountain SW. Elective pneumonectomy: factors associated with morbidity and operative mortality. Ann Thorac Surg 1992 Jul;54(1):84-8.

8. Massard G, Dabbȣ A, Wihlm JM, Kessler R, Barsotti P, Roeslin N et al. Pneumonectomy for chronic infection is a high risk procedure. Ann Thorac Surg 1996 Oct;62(4):1033-7.

9. Conlan AA, Lukanich JM, Shutz J, Huwitz SS. Elective pneumonectomy for benign lung disease: Modern-day mortality and morbidity. J Thorac Cardiovasc Surg 1995 Oct;110(4pt1): 1118-24.

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

11. Farncombe M. Dyspnea: assessment and treatment. Support Care Cancer 1997 Mar;5 (2);94-9.