Hasan AKIN, Aysun ÖLÇMEN, İbrahim DİNÇER, Özgür İŞGÖRÜCÜ, Necati ÇITAK, Atilla GÜRSES

Does the indication for completion pneumonectomy affect outcome?

Amaç: Bu çalışmada 20 yıllık deneyimimiz gözden geçirildi ve tamamlayıcı pnömonektominin morbidite ve mortalite oranlarını etkileyen faktörler araştırıldı. Çalışma planı: Haziran 1987 ile Haziran 2008 tarihleri arasında 54 hastaya kliniğimizde tamamlayıcı pnömonektomi yapıldı. Hastalar tamamlayıcı pnömonektomi endikasyonları açısından önceki ameliyatın komplikasyonu ya da kalan akciğerde yeni bir hastalık gelişimi nedeni ile iki gruba ayrıldı. Bulgular: Genel komplikasyon oranı %42.5 idi ve bu morbidite komplikasyon grubunda anlamlı ölçüde daha yüksek idi (p=0.04). Genel mortalite oranı %22 idi ve yaş mortalite için tek etkili faktör olarak bulundu (p=0.03). Sonuç: Yirmi yıllık deneyimimiz ve literatürdeki diğer bilgiler ışığında, tamamlayıcı pnömonektomide akıbeti kötü yönde etkileyen faktörün işlemin kendisinden ziyade, girişimin önceki ameliyatın komplikasyonu nedeni ile yapılması olduğu görüldü.

Endikasyon tamamlayıcı pnömonektomide akıbeti etkiler mi?

Background: In this report, we reviewed our 20-year experience and investigated the factors affecting morbidity and mortality of completion pneumonectomy. Methods: Fifty-four patients underwent completion pneumonectomy in our clinic between June 1987 and June 2008. Patients were divided into two groups according to their indications for completion pneumonectomy, either for a complication of the previous operation or a new disease in the remaining lung. Results: The overall complication rate was 42.5%, and this morbidity was significantly higher in the complication group (p=0.04). The overall mortality rate was 22%, and age was found as the only factor affecting mortality (p=0.03). Conclusion: The experience that we had over 20 years and the other information from the literature pointed out that the complications in the first operations adversely affected the outcome rather than the procedure itself in completion pneumonectomy.

PDF

___

1. Deslauriers J. Indications for completion pneumonectomy. Ann Thorac Surg 1988;46:133.
2. McGovern EM, Trastek VF, Pairolero PC, Payne WS. Completion pneumonectomy: indications, complications, and results. Ann Thorac Surg 1988;46:141-6.
3. Grégoire J, Deslauriers J, Guojin L, Rouleau J. Indications, risks, and results of completion pneumonectomy. J Thorac Cardiovasc Surg 1993;105:918-24.
4. Massard G, Lyons G, Wihlm JM, Fernoux P, Dumont P, Kessler R, et al. Early and long-term results after completion pneumonectomy. Ann Thorac Surg 1995;59:196-200.
5. Verhagen AF, Lacquet LK. Completion pneumonectomy. A retrospective analysis of indications and results. Eur J Cardiothorac Surg 1996;10:238-41.
6. Regnard JF, Icard P, Magdeleinat P, Jauffret B, Farés E, Levasseur P. Completion pneumonectomy: experience in eighty patients. J Thorac Cardiovasc Surg 1999;117:1095-101.
7. Mountain CF. The new International Staging System for Lung Cancer. Surg Clin North Am 1987;67:925-35.
8. Martini N, Melamed MR. Multiple primary lung cancers. J Thorac Cardiovasc Surg 1975;70:606-12.
9. Jungraithmayr W, Hasse J, Olschewski M, Stoelben E. Indications and results of completion pneumonectomy. Eur J Cardiothorac Surg 2004;26:189-96.
10. Muysoms FE, de la Rivière AB, Defauw JJ, Dossche KM, Knaepen PJ, van Swieten HA, et al. Completion pneumonectomy: analysis of operative mortality and survival. Ann Thorac Surg 1998;66:1165-9.
11. Chataigner O, Fadel E, Yildizeli B, Achir A, Mussot S, Fabre D, et al. Factors affecting early and long-term outcomes after completion pneumonectomy. Eur J Cardiothorac Surg 2008;33:837-43.
12. al-Kattan K, Goldstraw P. Completion pneumonectomy: indications and outcome. J Thorac Cardiovasc Surg 1995;110:1125-9.
13. Guggino G, Doddoli C, Barlesi F, Acri P, Chetaille B, Thomas P, et al. Completion pneumonectomy in cancer patients: experience with 55 cases. Eur J Cardiothorac Surg 2004;25:449-55.
14. Miller DL, Deschamps C, Jenkins GD, Bernard A, Allen MS, Pairolero PC. Completion pneumonectomy: factors affecting operative mortality and cardiopulmonary morbidity. Ann Thorac Surg 2002;74:876-83.
15. Van Schil PE, Brutel de la Rivière A, Knaepen PJ, van Swieten HA, Defauw JJ, van den Bosch JM. Second primary lung cancer after bronchial sleeve resection. Treatment and results in eleven patients. J Thorac Cardiovasc Surg 1992;104:1451-5.
16. Fujimoto T, Zaboura G, Fechner S, Hillejan L, Schröder T, Marra A, et al. Completion pneumonectomy: current indications, complications, and results. J Thorac Cardiovasc Surg 2001;121:484-90.
17. Terzi A, Lonardoni A, Falezza G, Scanagatta P, Santo A, Furlan G, et al. Completion pneumonectomy for non-small cell lung cancer: experience with 59 cases. Eur J Cardiothorac Surg 2002;22:30-4.