Factors Affecting Postoperative Complication in Pneumonectomy for Chronic Complicated Inflammatory Lung Disease

만성 염증성 폐질환의 전폐적축술 후 합병증에 영향을 미치는 요인

  • 최필조 (동아대학교 병원 흉부외과학교실) ;
  • 우종수 (동아대학교 병원 흉부외과학교실)
  • Published : 2000.01.01

Abstract

Background: this study was designed to estimate whether specific risk factors could increase the postoperative complication rate of pneumonectomy for chronic complicated inf-lammatory lung disease. Material and Method: Eighty-five patients underwent pneumon-ectomy for chronic complicated inflammatory lung disease(tuberculosis, 67 ; bronchiecasis 11; aspergio- losis, 4; others, 3) between January 1991 and August 1998. We performed a univariated statistical analysis to identify preoperative and intraoperative risk factors associated with postoperative complications, Result: There was no operative mortality. There were a total of 18 postoperative complications(22.2%) Bronchopleural fistula(BPF) and empyema occurred in 5(5.9%) and 2(2.4%) respectively. General complication rate was significantly higher in patients with right-sided pneumonectomy(p=.029) extrapleural pneu-monectomy(p=.009) and intraoperative pleural spillage due to cavity or lesion perforation (p=.004). The prevalence of BPF and empyema was higher in patients with right sided pneumonectomy(p=.007) extrapleural pneumonectomy(p=.015) and intraoperative pl- eural spillage due to cavity or lesion perforation(p=.003) which is as the same results as gen-eral complication rate. Conclusion: The postoperative complication rate of pneumone-ctomy for chronic complicated lung disease is accptably low. But it is increase in patients with right sided pneumonectomy extrapleural pneumonectomy and intraoperative pleural spillage due to cavity or lesion perforation. therefore more careful and meticulous intra-operatve management are needed in right sided extrapleural pneumonectomy without intra- pleural spillage.

Keywords

References

  1. Ann Thorac Surg v.46 Completion pneumonectomy:indication, complications and results McGovern EM;Trastek VF;Pairolero PC,(et al.)
  2. Thorax v.45 Unilateral plosttuberculous lung destruction:the left bronchus syndrome Ashour M;Pandya L;Mezraqji A,(et al.)
  3. Thotacic Surgery Pomerantz M;Scannell JG;Ginsberg RJ, (et al.)(Eds.)
  4. Ann Thorac Surg v.52 Surgical management of resistant mycobacterial tuberculosis and othe mycobacterial pulmonary infections Pomerantz M;Madsen L;Goble M,(et al.)
  5. Ann Thorac Surg v.61 Prospective analysis of pneumonectomy:risk factors for major morbidity and cardiac dysrhythmias Harpole DH;Liptay MJ;DeCamp MM,(et al.)
  6. Ann Thorac Surg v.54 Pleuropulmonary aspergilloma: clinical spectrum and results of surgical treatment Massard G;Roeslin N;Wihlm JM, (et al.)
  7. Ann Thorac Surg v.59 Subclavian artery branch ligation reduces hemorrage during resection of pulmonary aspergilloma Niwa H;Yamakawa Y;Fukai I,(et al.)
  8. Ann Thorac Surg v.48 Surgical resection for complications of pulmonary tuberculosis Reed CE;Parker EF;Crawford FA.
  9. Ann Thorac Surg v.60 Pneumonectomy for infection(letter). Fell SC.
  10. 대흉외지 v.25 체외 순환을 이용한 우측 소매 전폐적출술 치험 1례 최필조;성시찬;우종수