FACTORS AFFECTING POSTOPERATIVE MORBIDITY AND MORTALITY IN DESTROYED LUNG

Background. The presence of specific risk factors can increase the pos toperative complication rate of pneumonectomy for destroyed lung. Meth ods. Our experience in 118 consecutive patients who underwent pneumone ctomy for destroyed lung over a 10-year period was retrospectively ana lyzed to evaluate the effect of specific risk factors on postoperative complications. The significance of tuberculosis, right pneumonectomy, preoperative empyema, and duration of illness longer than 36 months w as examined by univariate analyses. Results. The most common underlyin g diseases were nonspecific bronchiectasis (n = 52) and tuberculosis ( n = 43). Sixty-day or in-hospital morbidity and mortality rates were 1 1.9% and 5.9%, respectively. The combined morbidity and mortality rate was significantly higher in patients with preoperative empyema (p < 0 .003), tuberculosis (p < 0.03), and right pneumonectomy (p < 0.03). Th e prevalence of bronchopleural fistula was higher in patients with pre operative empyema (p < 0.02) and patients with tuberculosis (p < 0.03) . Conclusions. The postoperative complication rate of pneumonectomy fo r destroyed lung is acceptably low. However, it is increased by preope rative empyema, tuberculosis, and right-sided resection. (C) 1997 by T he Society of Thoracic Surgeons.