Pneumonectomy for inflammatory lung disease✩

Blyth, David

doi:10.1016/s1010-7940(00)00526-1

Cited by 55 publications

(47 citation statements)

References 19 publications

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“…This procedure often followed by postoperative complications with an incidence of 20-60% and many of them were life threatening and require appropriate immediate management (10). For patients with complex inflammatory lung disease, such as tuberculosis, undergoing this procedure was combined with even higher mortality and morbidity (11,12). There has been a recent Demographic information, estimated blood loss (EBL), operation time (OR time), dissected lymph nodes numbers, VAPS, postoperative chest drainage time, the length of stay (LOS), transfusion requirement and postoperative complications were recorded respectively.…”

Section: Discussionmentioning

confidence: 99%

Video-assisted versus conventional thoracotomy pneumonectomy: a comparison of perioperative outcomes and short-term measures of convalescence

Liu¹,

Gao²,

Zhang³

et al. 2016

J. Thorac. Dis.

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Background: Pneumonectomy is a proven treatment for lung diseases. We sought to present a comparison between video-assisted thoracic surgery pneumonectomy (VATS-P) and conventional thoracotomy pneumonectomy (CP) on perioperative outcomes and short-term measures of convalescence.Methods: A retrospective cohort study was performed to assess perioperative outcomes among patients underwent VATS-P and CP. A total of 32 patients undergoing VATS-P were matched 2:1 about comorbidity, surgical indication, tumour size and lesion location to a previous cohort of 64 patients who underwent CP.Demographic and perioperative data were obtained. Statistical analysis was performed.Results: Mean patient age was 55.4 years for both groups, with equal sex distribution. Pneumonectomy for malignant and benign lesion patients was evaluated individually. For malignant tumour patients, median tumour size was 3.9 cm for both groups. There was no difference between VATS-P and CP cases in transfusion rates (2% vs. 10%, P=0.50), dissected lymph node numbers (11.9 vs. 14.2, P=0.26), dissected lymph node stations (5.0 vs. 4.9, P=0.75), estimated blood loss (226.0 vs. 261.3 mL, P=0.40), complication rate (20.0% vs. 22.5%, P=0.82), postoperative drainage time (5.9 vs. 6.2, P=0.50) or length of hospital stay (7.5 vs. 8.1, P=0.50). Operation time in VATS-P was higher than conventional groups (187.5 vs. 146.3 min, P=0.00) but the mean pain score was significantly less. For benign patients, over 1,000 mL blood losing (1,033.3 vs. 1,233.3 mL, P=0.78) and 180 minutes (186.6 vs. 105.8, P=0.73) OR time was found in both groups. The Length of stay (7.6 vs. 6.3 d, P=0.57), transfusion rates (66.7% vs. 33.3%), complications rates (zero in both group) and length of drainage (6.7 vs. 6.7 d, P=1.0) between two groups are identical.Conclusions: Complete video-assisted thoracic surgery (VATS) pneumonectomy is feasible and safe technique and can be recommended as a surgical treatment for lung cancer patients. However, long-term benefits need to be evaluated by further studies and large sample tests.

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Section: Discussionmentioning

confidence: 99%

Video-assisted versus conventional thoracotomy pneumonectomy: a comparison of perioperative outcomes and short-term measures of convalescence

Liu¹,

Gao²,

Zhang³

et al. 2016

J. Thorac. Dis.

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“…Alternatively, if the majority of cavitation is peripheral, it can be debrided, although this may be associated with an increased risk of late complications, including bleeding and air leak (24). A significant number of patients also have empyema at the time of surgery, and the risk of postoperative pleural space infection and stump leak, particularly if pneumonectomy is required, is markedly increased unless preventive measures are taken (2).…”

Section: Discussionmentioning

confidence: 99%

Surgical Management of Acute Necrotizing Lung Infections

Reimel

Krishnadasen

Cuschieri

et al. 2006

Canadian Respiratory Journal

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BACKGROUND: Surgical resection for acute necrotizing lung infections is not widely accepted due to unclear indications and high risk.OBJECTIVE: To review results of resection in the setting of acute necrotizing lung infections.METHODS: A retrospective review of patients who underwent parenchymal resection between January 1, 2000, and January 1, 2006, for management of necrotizing pneumonia or lung gangrene.RESULTS: Thirty-five patients underwent resection for lung necrosis. At the time of consultation, all patients presented with pulmonary sepsis, and also had the following: empyema (n=17), hemoptysis (n=5), air leak (n=7), septic shock requiring pressors (n=8) and inability to oxygenate adequately (n=7). Twenty-four patients were ventilated pre-operatively. Eleven patients had frank lobar gangrene, and the other patients had combinations of necrotizing pneumonia and abscesses. In 10 patients, preresection procedures were performed, including percutaneous drainage of an abscess (n=4), thoracoscopic decortication (n=4) and open decortication (n=2). Procedures included pneumonectomy (n=4), lobectomy (n=18), segmentectomy (n=2), wedge resection (n=4) and debridement (n=7). There were three (8.5%) postoperative deaths – two due to multiple organ failure and one due to anoxic brain injury. All patients not ventilated preoperatively were weaned from ventilatory support within three days. Of those ventilated preoperatively, three died, while four remained chronically ventilator dependent.CONCLUSIONS: Surgical resection for necrotizing lung infections is a reasonable option in patients with persistent sepsis who are failing medical therapy. Ventilated patients have a worse prognosis but can still be candidates for resection. Patients who are hemodynamically unstable appear to have better outcomes if they can be stabilized before resection.

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“…However, the pneumothorax recurred because of pulmonary fistula and the patient developed Aspergillus empyema. The mortality rates after pneumonectomy for a chronic infection range from 1.2-9.5% (12)(13)(14)(15). The rate of morbidities, such as empyema or bronchopleural fistula, is suggested to be relatively high (14,15), and empyema occurs frequently after pneumonectomy, especially in patients with preexisting empyema (16).…”

Section: Discussionmentioning

confidence: 99%

Successful Treatment of <i>Aspergillus</i> Empyema Using Open Window Thoracostomy Salvage Treatment and the Local Administration of an Antifungal Agent

et al. 2016

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A 76-year-old woman received long-term immunosuppressive treatment for collagen vascular diseaseassociated interstitial pneumonia. The patient developed a cavitary mass lesion in the right lower lung field, and both nontuberculous mycobacteria and Aspergillus spp. were isolated after bronchial washing. The patient underwent a right lower lobectomy but developed Aspergillus empyema. Empyema due to Aspergillus spp. is a rare and life-threatening condition; however, the standard therapeutic strategies for treating Aspergillus empyema are not clear. We herein report a case of Aspergillus empyema that was successfully treated with a combination therapy which included open-window thoracostomy and the administration of antifungal agents (systemic micafungin and local amphotericin-B).

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Pneumonectomy for inflammatory lung disease✩

Abstract: This ongoing study shows pneumonectomy for inflammatory lung to be safe, with good results. Tuberculosis, being so common, adequate pre-operative and operative cover with anti-tuberculosis drugs may enhance results.

Cited by 55 publications

References 19 publications

Video-assisted versus conventional thoracotomy pneumonectomy: a comparison of perioperative outcomes and short-term measures of convalescence

Video-assisted versus conventional thoracotomy pneumonectomy: a comparison of perioperative outcomes and short-term measures of convalescence

Surgical Management of Acute Necrotizing Lung Infections

Successful Treatment of <i>Aspergillus</i> Empyema Using Open Window Thoracostomy Salvage Treatment and the Local Administration of an Antifungal Agent

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