Invited Commentary

Commentary on “Pneumonectomy for Non–Small Cell Lung Cancer: Outcomes Analysis”

Authors: Paul D. Kiernan, MD

Abstract

Pneumonectomy is associated with the highest morbidity and mortality rates of all elective pulmonary resections1–3; thus, Kalathiya and Saha’s retrospective outcomes analysis is a welcome addition to this month’s issue of the Southern Medical Journal.4 The postpneumonectomy results of 100 consecutive patients were retrospectively reviewed from 1998 to 2009. Postoperative mortality was defined as any in-hospital death or within 30 days of surgery if the patient had been discharged. Major morbidity was experienced by 39%, most commonly atrial fibrillation. Operative mortality was 11%. Mortality was highest after neoadjuvant therapy (14.3%), with factors being right-sided surgery (17.4%) and patients older than 70 (18.2%).

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References

1. Ferguson MK. Assessment of operative risk for pneumonectomy. Chest Surg Clin N Am 1999; 9: 339–351.
 
2. Martin J, Ginsberg RJ, Abolhoda A, et al. Morbidity and mortality after neoadjuvant therapy for lung cancer: the risks of right pneumonectomy. Ann Thorac Surg 2001; 72: 1149–1154.
 
3. Bernard A, Deschamps C, Allen MS, et al. Pneumonectomy for malignant disease: factors affecting early morbidity. J Thorac Cardiovasc Surg 2001; 121: 1076–1082.
 
4. Kalathiya RJ, Saha SP. Pneumonectomy for non–small cell lung cancer: outcomes analysis. South Med J 2012; 105: 350–354.
 
5. Kiernan PD, Khandhar SJ, Fortes DL, et al. Thoracic surgery in octogenarians: CVTSA/Inova Fairfax Hospital experience, 1990–2009. Am Surg 2011; 77: 675–680.