Safety and risk factors for the morbidity and mortality of pneumonectomies: a retrospective 10-year study in a single institution

Abstract

Pneumonectomy is a major lung surgery with a high incidence of post-operative morbidity and mortality. This study aims to identify risk factors that affect post-operative outcome, therefore determining the safety of pneumonectomy in specific groups.

A total of 63 patients submitted to pneumonectomy, from February 2008 to 2018 were included in our retrospective study. Age, gender, side of surgical intervention, underlying disease, pre-operative symptoms, tobacco and alcohol abuse and history of respiratory and cardiovascular disease were assessed. Early and late post-operative complications, as well as death were our major analysed outcomes. We have performed logistic regression analysis on preoperative variables in order to determine their impact on major adverse outcomes.

We found a 9,8% surgery-related mortality and 1-year survival rate of 76,2% in our patients. The incidence of early complications in our population was of 35% while eleven patients (17,4%) developed late post-operative complications. No statistical difference was found when comparing survival time between genders or age groups. Right sided pneumonectomies’ seem to be associated with an higher mortality, while smoking increases early post-operative complications.

Pneumonectomy is a viable option regardless of age whenever the patient has a good functional and cardiopulmonary status. While gender and diagnostic group do not seem to influence adverse event risk after a pneumonectomy, benign disease might increase post-surgical adverse outcome risk. Smoking increases post-operative complications and pre-operative cessation should be encouraged.