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Jean-Marie Wihlm
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Ann Thorac Surg 1996;62:1033-1037
© 1996 The Society of Thoracic Surgeons


Original Articles: General Thoracic

Pneumonectomy for Chronic Infection Is a High-Risk Procedure

Gilbert Massard, MD, Ahmad Dabbagh, MD, Jean-Marie Wihlm, MD, Romain Kessler, MD, Pierre Barsotti, MD, Norbert Roeslin, MD, Georges Morand, MD

Department of Thoracic Surgery, University Hospital of Strasbourg, Strasbourg, France

Accepted for publication May 21, 1996.

Background. The purpose of this study was to estimate operative risk, and to identify indicators of adverse prognosis, in patients undergoing pneumonectomy for chronic infection.

Methods. Twenty-five patients aged 41 ± 15 years underwent pneumonectomy (three completions) for chronic infection: sequelae of tuberculosis, 15; cystic bronchiectasis, 9; and radiation pneumonitis, 1. Eight patients had aspergilloma (7 after tuberculosis, 1 with radiation pneumonitis).

Results. Operative mortality was 4%. Operative blood loss was estimated at 1,983 ± 1,424 mL, ranging from 150 to 5,600 mL. A single patient required reexploration. Eight patients (32%) had empyema, and a further 3 (12%) had bronchopleural fistula; thoracoplasty was required for 10 (40%). Sequelae of tuberculosis heralded increased operative bleeding (t = 2.884; p < 0.005). Incidence of empyema or bronchopleural fistula was increased in patients with sequelae of tuberculosis ({chi}2 = 3.896; p < 0.05), patients with aspergilloma ({chi}2 = 4.588; p < 0.05), patients in whom the parenchymal cavities were entered ({chi}2 = 11.5; p < 0.001), and those in whom blood loss was in excess of 1,000 mL ({chi}2 = 4.911; p < 0.05).

Conclusions. We conclude that pneumonectomy is a high-risk procedure, especially in patients with sequelae of tuberculosis.


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Ann. Thorac. Surg. 1996 62: 1037-1038. [Extract] [Full Text]



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