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European Journal of Cardio-Thoracic Surgery, Vol 10, 238-241, Copyright © 1996 by European Association for Cardio-thoracic Surgery
AF Verhagen and LK Lacquet
Between 1970 and 1993, 446 patients underwent pneumonectomy. Completion
pneumonectomy was performed in 37 patients (8.3%): 34 men and 3 women, with
a mean age of 61 years (range 20-78 years). Indications were benign disease
in 4 patients and carcinoma in 33. Of the latter, 21 patients underwent
resection for metachronous lung cancer, 6 for recurrent lung cancer, 4 for
previous incomplete resection, 1 for primary lung cancer after previous
resection for benign disease and 1 patient after previous segmentectomy for
metastasis. The mean interval between first operation and completion
pneumonectomy was 41 months (range 1-187 months) for the whole group, 30
months for benign disease and 42 months for carcinoma. The overall
operative mortality was 6/37 (16.2%); 1/4 patients with benign disease and
5/33 (15.2%) patients with carcinoma. Nine patients (29%) had one or more
major non-fatal complication. Actuarial 3- and 5-year survival rates were
41.0% and 24.5% for the entire group, 75% at both times for patients with
benign disease, 36.4% and 18.3% for all patients with carcinoma at the time
of completion pneumonectomy and 24.3% and 14.5% for patients with
metachronous or recurrent lung cancer. For 15 patients with stage I or II
metachronous lung cancer, the 3- and 5-year survival rates were 33.9% and
16.9%. All six patients with stage III metachronous cancer died within 18
months. In conclusion, completion pneumonectomy carries a high operative
mortality and morbidity. Long-term survival is negatively influenced by
stage III lung cancer.
ARTICLES
Completion pneumonectomy. A retrospective analysis of indications and results
Department of Thoracic and Cardiac Surgery, University Hospital St. Radboud, Nijmegen, The Netherlands.
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