Long-Term Outcomes and Risk Factor Analysis after Pneumonectomy for the Sequelae of Pulmonary Tuberculosis.
- Author:
Young Tae KIM
1
;
Hong Kwan KIM
;
Sook Whan SUNG
;
Joo Hyun KIM
Author Information
1. Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Korea.
- Publication Type:Original Article
- Keywords:
Pulmonary tuberculosis;
Pneumonectomy;
Empyema;
Bronchopleural fistula;
Survival rate
- MeSH:
Bronchi;
Constriction, Pathologic;
Empyema;
Female;
Fistula;
Humans;
Lung;
Male;
Mortality;
Multivariate Analysis;
Pathology;
Pneumonectomy*;
Prevalence;
Retrospective Studies;
Risk Factors*;
Sputum;
Survival Rate;
Tuberculosis, Pulmonary*;
Wound Infection
- From:The Korean Journal of Thoracic and Cardiovascular Surgery
2002;35(7):535-541
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: The prevalence of pulmonary tuberculosis remains high in several areas of the world, and pneumonectomy is often necessary to treat the sequelae of the disease. We retrospectively analyzed the morbidities, mortalities, and long-term outcomes after pneumonectomy for the treatment of tuberculous sequelae. MATERIAL AND METHOD: Between 1981 and 2001, 94 patients underwent either pneumonectomy or extrapleural pneumonectomy for the treatment of tuberculous sequelae. There were 44 males and 50 females. The mean age was 40(16~68) years. The pathology included destroyed lung in 80, main bronchus stenosis in 10, and both lesions in 4. Surgical procedures were pneumonectomy in 47, extrapleural pneumonectomy in 43, and completion pneumonectomy in 4. RESULTS: One patient died postoperatively due to empyema. Twenty-three complications occurred in 20 patients; empyema in 15(including 7 bronchopleural fistulas), wound infection in 5, and others in 3. Univariate analysis revealed presence of empyema, extrapleural pneumonectomy, prolonged operation time, and old age as risk factors of postpneumonectomy empyema. In multivariate analysis, old age and low preoperative FEV1 were risk factors of empyema. Low preoperative FEV1 was the risk factor of bronchopleural fistula(BPF) in univariate analysis. Low preoperative FEV1, positive sputum AFB, and presence of aspergilloma were risk factors of BPF in multivariate analysis. There were twelve late deaths. Actuarial 5-and 10-year survival rates were 94+/-3% and 87+/-4 %, respectively. CONCLUSION: Pneumonectomy could be performed with acceptable mortality and morbidity, and could achieve good long-term survival for the treatment of tuberculous sequelae. In patients with risk factors, special care is recommended to prevent postoperative empyema or bronchopleural fistula.
