Objective: Because completion pneumonectomy is a procedure reputed to place
patients at risk, we reviewed our results with the objective of identifyin
g factors that influence complications and survival. Methods: In a 25-year
period, 80 completion pneumonectomies were performed after first operations
for 17 cases of benign disease and 63 cases of lung cancer (89% stages I a
nd II), with 7 of the latter patients receiving postoperative radiotherapy.
Completion pneumonectomy was performed in 18 cases of benign disease and 6
2 cases of lung cancer: 28 second primary cancers, 26 recurrent cancers, 3
metastases, and 5 primary cancers in patients previously operated on for be
nign disease. Results: No intraoperative deaths occurred. Postoperative mor
tality rates were 5% for the entire series, 6.4% for patients operated on f
or cancer, and 0% for patients operated on for benign diseases. Patients pr
eviously irradiated and those operated on for infectious disease were at ri
sk for postoperative empyema and fistula formation. In the cancer treatment
group the actuarial 5-year survival was 36%, without significant differenc
e between patients with recurrent and second primary lung cancers. The actu
arial 5-year survivals were 51% for patients with stage I disease, 42% for
patients with stage II disease, and 18% for patients with stage IIIA diseas
e (P < .05), Conclusions: Completion pneumonectomy can be performed with an
acceptable operative mortality rate and offers a second chance for cure to
patients with cancer. Patients previously irradiated and those requiring c
ompletion pneumonectomy for infectious benign disease are at risk for posto
perative complications.