The Long-term Outcomes of Completion Pneumonectomy from a Tertiary Center

Abstract

Aim: Completion pneumonectomy is a compelling procedure that is associated with high rates of mortality and morbidity. The aim of the present study was to investigate long-term surgical and oncologic outcomes of completion pneumonectomy. Methods: A retrospective review was conducted of 66 patients who underwent completion pneumonectomy in our clinic between 2006 and 2016. The patients were divided into two groups. The patients undergoing classical completion pneumonectomy (n=58), 56 had a malignant disease (non-small-cell lung carcinoma) and two patients had a benign disease. Eight patients had undergone rescue completion pneumonectomy; bronchopleural fistula in five patients, pulmonary venous occlusion in two patients, and upper lobe torsion in one patient. Results: The median follow-up period was 37.6 months. The overall mortality rate was 7.6%. The amount of intraoperative bleeding and the percentage decrease in hemoglobin levels (p=0.003) were prognostic factors affecting mortality. The postoperative complication rate was 41.4% in classical completion pneumonectomy and 50% in rescue completion pneumonectomy (p=0.64), and it was significantly higher in patients older than 65 years (p=0.04). The 5-year survival rate was 58% in malignant disease. Conclusion: Completion pneumonectomy procedure has satisfactory oncological and surgical results when performed in experienced centers on selected patients. The morbidity and mortality rates of classical completion pneumonectomy and rescue completion pneumonectomy are similar.