Progress on Prevention and Treatment of Postpneumonectomy Complications_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

 WANGZhi-hai , SUNXiao-yan , GUOMing

Department of Cardiothoracic Surgery, PLA 174 th Clinical College of Anhui Medical University, Xiamen 361000, Fujian, P. R. China;

Corresponding?author：

WANGZhi-hai, Email: xiahouhaiocean@sina.com

Keywords：

Pneumonectomy; Complication; Prevention; Treatment; Model lung

DOI：

10.7507/1007-4848.20150100

Video：

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Pneumonectomy is known as an effective treatment of lung cancer, lung tuberculosis, and damaged lung. But the incidences of complications and mortality are significantly higher in patients undergoing pneumonectomy than those undergoing lobectomy. The complication rate within 30 days after pneumonectomy is 11%-49% and the mortality is 3%-25%. Mortality of right pneumonectomy is triple that of left pneumonectomy. Postpneumonectomy complications include cardiopulmonary failure, bronchopleural fistula and postpneumonectomy syndrome. Besides the symptomatic treatment, which includes flushing drainage, plugging and operation, observation and prompt diagnosis are necessary for prevention. This review is focused on the prevention and treatment of complications after pneumonectomy.

Citation： WANGZhi-hai, SUNXiao-yan, GUOMing. Progress on Prevention and Treatment of Postpneumonectomy Complications. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2015, 22(4): 380-384. doi: 10.7507/1007-4848.20150100 Copy

1.	Klemperer J, Ginsberg RJ.Morbidity and mortality after pneumo-nectomy.Chest surg clin N Am, 1999, 9(3):515-525.
2.	Chandrashekhara SH, Bhalla AS, Sharma R, et al.Imaging in postpneumonectomy complications:a pictorial review.J Cancer Res Ther, 2011, 7(1):3-10.
3.	Harpole DH, Liptay MJ, DeCamp MM Jr, et al.Prospective analysis of pneumonectomy:risk factors for major morbidity and cardiac dysrhythmias.Ann Thorac Surg, 1996, 61(3):977-982.
4.	翁毅敏, 廖洪映, 李昀, 等.肺癌全肺切除術后心肺并發癥的防治.中山大學學報(醫學科學版), 2007, 28(z1):89-91.
5.	武艷.肺癌術后心律失常的危險因素分析.腫瘤學雜志, 2011, 17(12):917-919.
6.	Fan Y, Zhang AM, Xiao YB.Glucose-insulin-potassium therapy in adult patients undergoing cardiac surgery a meta-analysis.Eur J Cardiothorac Surg, 2011, 40(1):192-199.
7.	張競, 王云喜, 初向陽, 等.肺癌全肺切除術后常見并發癥臨床分析.第三軍醫大學學報, 2012, 34(9):893-895.
8.	吳魯卿, 張春芳, 張恒, 等.210例肺癌全肺切除臨床分析.中南大學學報(醫學版), 2008, 33(3):270-273.
9.	常濤, 張鑄.肺癌患者術后院內肺部感染的相關因素分析.中國胸心血管外科臨床雜志, 2013, 20(2):176-180.
10.	李學昌, 王偉, 尚立群, 等.高齡患者全肺切除術后心律失常發生.山東醫藥, 2013, 53(6):83-85.
11.	Reed CE, Dorman BH, Spinale FG.Assessment of right ventricular contractile performance after pulmonary resection.Ann Thorac Surg, 1993, 56(3):426-432.
12.	Swartz DE, Lachapelle K, Sampalis J, et al.Perioperative mortality after pneumonectomy:analysis of risk factors and review of the literature.Canadian J Surgery, 1997, 40(6):437-443.
13.	甄福喜, 趙欣, 張偉, 等.肺癌全肺切除術后早期右心功能不全的危險因素分析.臨床腫瘤學雜志, 2013, 17(11):1006-1008.
14.	蘇梓航, 葉穗暉, 楊正心.ACEI防治一側全肺切除術后心功能不全的效果分析.廣州醫藥, 2009, 40(1):16-19.
15.	陳波, 甘耐炎, 陳軍, 等.全肺切除治療肺癌72例臨床分析.中國當代醫藥, 2011, 33(9):1176-1178.
16.	黃江遠.老年肺癌患者行全肺切除術的圍術期處理.中國當代醫藥, 2011, 18(12):176-179.
17.	丁嘉安, 姜格寧.肺切除術后近期死亡原因分析及對策.中華結核和呼吸雜志, 2000, 23(4):232-234.
18.	Koh WJ, Kim YH, Kwon OJ, et al.Surgical treatment of pulmonary diseases due to nontuberculous mycobacteria.J Korean Med Sci, 2008, 23(3):397-401.
19.	徐寶寧, 田大力.肺切除術后支氣管胸膜瘺的防治體會.山東醫藥, 2013, 53(28):91-92.
20.	錢可寶, 張勇, 巫正偉, 等.肺切除術后并發支氣管胸膜瘺的臨床分析.昆明醫學院學報, 2012, 33(3):36-38.
21.	Pop D, Nadeemy AS, Venissac N, et al.Bronchopleural fistula:the Damocles sword of all pneumonectomies.Interact Cardiovasc Thorac Surg, 2011, 13(1):107-108.
22.	張寶石, 于長海, 劉穎, 等.全肺切除術后支氣管胸膜瘺的早期手術治療.南方醫科大學學報, 2010, 30(5):1147-1149.
23.	王濤, 朱余明, 高文, 等.肺切除術后支氣管胸膜瘺的原因分析和處理.中國現代醫學雜志, 2009, 19(15):2375-2377.
24.	Kilic A.Sciurba F, Luketich J, et al.Spontaneous bronchopleural-fistula following lung volume reduction surgery for emphysema.Interact Cardiovasc Thorac Surg, 2009, 8(4):442-443.
25.	Wolter A, Scholz T, Diedrichson J, et al.Bronchopleural fistula after pneumonectomy:interdisciplinary surgical closure by an ipsilateral pedicled latissimus dorsi flap supported by video-assisted thoracoscopy.J Plast Reconstr Aesthet Surg, 2013, 66(11):1600-1603.
26.	張志民, 辛國華, 侯繼申, 等.肺切除術后支氣管胸膜瘺的外科治療.江蘇醫藥, 2012, 38(6):725-726.
27.	Tayama K, Eriguchi N, Futamata Y, et al.Modified Dumon stent for the treatment of a bronchopleural fistula after pnumonectomy.Ann Thorac Surg, 2003, 75(1):290-292.
28.	Ishikawa K, Kato T, Aragaki M, et al.Endobronchial closure of a bronchopleural fistula using a fibrin glue-coated collagen patch and fibrin glue.Ann Thorac Cardiovasc Surg, 2013, 19(6):423-427.
29.	Wright CD, Wain JC, Mathisen DJ, et al.Postpneumonectomy bronchopleural fistula after sutured bronchial closure:Incidence, risk factors and management.J Thorac Cardiovasc Surg, 1996, 112(5):1367-1371.
30.	王斌, 李金東, 張興義, 等.自體帶蒂組織修補肺切除術后支氣管胸膜瘺.中國現代藥物應用, 2013, 7(14):68-69.
31.	張真銘, 王允.肺癌術后支氣管胸膜瘺致死性大咯血經驗.中國肺癌雜志, 2012, 15(1):39-43.
32.	羅清泉, 趙曉菁, 周允中, 等.肺癌全肺切除術后支氣管胸膜瘺的原因分析和處理.中國癌癥雜志, 2003, 13(4):373-375.
33.	Bédard EL, Uy K, Keshavjee S.Postpneumonectomy syndrome:a spectrum of clinical presentations.Ann Thorac Surg, 2007, 83(3):1185-1188.
34.	Lloyd MS, Wallis C, Muthialu N, et al.Treatment of postpneumo-nectomy syndrome with tissue expanders:the Great Ormond Street Hospital experience.J Plast Reconstr Aesthet Surg, 2014, 67(5):725-728.
35.	Valji AM, Maziak DE, Shamji FM, et al.Postpneumonectomy synd-rome recognition and management.Chest, 1998, 114(6):1766-1769.
36.	Choi L, LaQuaglia PM, Cordeiro GP.Prevention of postpneumonec-tomy syndrome in children with prophylactic tissue expander insertion.J Pediatr Surg, 2012, 47(7):1354-1357.
37.	Zahid I, Routledge T, Billè A, et al.What is the best treatment of postpneumonectomy empyema?Interact Cardiovasc Thorac Surg, 2011, 12(2):260-264.
38.	Sharifpour M, Bittner EA.Postpneumonectomy syndrome:a case of shifting priorities.Anesthesiology, 2014, 121(6):1334.
39.	Kreisel D, Krupnick AS, Huddleston CB.Outcomes and late complications after pulmonary resections in the pediatric population.Semin Thorac Cardiovasc Surg, 2004, 16(3):215-219.
40.	Saatvedt K, Hoel T, Westvik J, et al.Correction of postpneumonec-tomy syndrome in infants with saline-filled expandable prosthesis.Interact Cardiovasc Thorac Surg, 2011, 13(1):89-90.
41.	McRae MC, Detterbeck FC, Narayan D.Correction of postpneumo-nectomy syndrome using a custom implant.BMJ Case Rep, 2011.doi:10.1136/bcr.11.2010.3523.
42.	Podevin G, Larroquet M, Camby C, et al.Postpneumonectomy syndrome in children:advantages and long-term follow-up of expandable prosthesis.Pediatr Surg, 2001, 36(9):1425-1427.
43.	支修益, 衛生部臨床路徑審核專家委員會胸外科專家組.胸外科圍手術期氣道管理專家共識(2012年版).中國胸心血管外科臨床雜志, 2013, 20(3):251-255.
44.	Jablonski S, Brocki M, Klejszmit P, et al.Repair of postpneumonec-tomy bronchopleural fistula using pedicled pericardial flap suppo-rted by fibrin glue.Int Wound J, 2013 Apr 5.doi:10.1111/iwj.12072.
45.	Spartalis E, Tomos P, Konofaos P, et al.The effect of autologous platelet-rich plasma on bronchial stump tissue granulation after pneumonectomy:experimental study.ISRN Surg, 2013:864350.
46.	Shen RK, Wain CJ, Wright DC, et al.Postpneumonectomy syndrome:surgical management and long-term results.J Thorac Cardiovasc Surg, 2008, 135(6):1210-1216.

1. Klemperer J, Ginsberg RJ.Morbidity and mortality after pneumo-nectomy.Chest surg clin N Am, 1999, 9(3):515-525.
2. Chandrashekhara SH, Bhalla AS, Sharma R, et al.Imaging in postpneumonectomy complications:a pictorial review.J Cancer Res Ther, 2011, 7(1):3-10.
3. Harpole DH, Liptay MJ, DeCamp MM Jr, et al.Prospective analysis of pneumonectomy:risk factors for major morbidity and cardiac dysrhythmias.Ann Thorac Surg, 1996, 61(3):977-982.
4. 翁毅敏, 廖洪映, 李昀, 等.肺癌全肺切除術后心肺并發癥的防治.中山大學學報(醫學科學版), 2007, 28(z1):89-91.
5. 武艷.肺癌術后心律失常的危險因素分析.腫瘤學雜志, 2011, 17(12):917-919.
6. Fan Y, Zhang AM, Xiao YB.Glucose-insulin-potassium therapy in adult patients undergoing cardiac surgery a meta-analysis.Eur J Cardiothorac Surg, 2011, 40(1):192-199.
7. 張競, 王云喜, 初向陽, 等.肺癌全肺切除術后常見并發癥臨床分析.第三軍醫大學學報, 2012, 34(9):893-895.
8. 吳魯卿, 張春芳, 張恒, 等.210例肺癌全肺切除臨床分析.中南大學學報(醫學版), 2008, 33(3):270-273.
9. 常濤, 張鑄.肺癌患者術后院內肺部感染的相關因素分析.中國胸心血管外科臨床雜志, 2013, 20(2):176-180.
10. 李學昌, 王偉, 尚立群, 等.高齡患者全肺切除術后心律失常發生.山東醫藥, 2013, 53(6):83-85.
11. Reed CE, Dorman BH, Spinale FG.Assessment of right ventricular contractile performance after pulmonary resection.Ann Thorac Surg, 1993, 56(3):426-432.
12. Swartz DE, Lachapelle K, Sampalis J, et al.Perioperative mortality after pneumonectomy:analysis of risk factors and review of the literature.Canadian J Surgery, 1997, 40(6):437-443.
13. 甄福喜, 趙欣, 張偉, 等.肺癌全肺切除術后早期右心功能不全的危險因素分析.臨床腫瘤學雜志, 2013, 17(11):1006-1008.
14. 蘇梓航, 葉穗暉, 楊正心.ACEI防治一側全肺切除術后心功能不全的效果分析.廣州醫藥, 2009, 40(1):16-19.
15. 陳波, 甘耐炎, 陳軍, 等.全肺切除治療肺癌72例臨床分析.中國當代醫藥, 2011, 33(9):1176-1178.
16. 黃江遠.老年肺癌患者行全肺切除術的圍術期處理.中國當代醫藥, 2011, 18(12):176-179.
17. 丁嘉安, 姜格寧.肺切除術后近期死亡原因分析及對策.中華結核和呼吸雜志, 2000, 23(4):232-234.
18. Koh WJ, Kim YH, Kwon OJ, et al.Surgical treatment of pulmonary diseases due to nontuberculous mycobacteria.J Korean Med Sci, 2008, 23(3):397-401.
19. 徐寶寧, 田大力.肺切除術后支氣管胸膜瘺的防治體會.山東醫藥, 2013, 53(28):91-92.
20. 錢可寶, 張勇, 巫正偉, 等.肺切除術后并發支氣管胸膜瘺的臨床分析.昆明醫學院學報, 2012, 33(3):36-38.
21. Pop D, Nadeemy AS, Venissac N, et al.Bronchopleural fistula:the Damocles sword of all pneumonectomies.Interact Cardiovasc Thorac Surg, 2011, 13(1):107-108.
22. 張寶石, 于長海, 劉穎, 等.全肺切除術后支氣管胸膜瘺的早期手術治療.南方醫科大學學報, 2010, 30(5):1147-1149.
23. 王濤, 朱余明, 高文, 等.肺切除術后支氣管胸膜瘺的原因分析和處理.中國現代醫學雜志, 2009, 19(15):2375-2377.
24. Kilic A.Sciurba F, Luketich J, et al.Spontaneous bronchopleural-fistula following lung volume reduction surgery for emphysema.Interact Cardiovasc Thorac Surg, 2009, 8(4):442-443.
25. Wolter A, Scholz T, Diedrichson J, et al.Bronchopleural fistula after pneumonectomy:interdisciplinary surgical closure by an ipsilateral pedicled latissimus dorsi flap supported by video-assisted thoracoscopy.J Plast Reconstr Aesthet Surg, 2013, 66(11):1600-1603.
26. 張志民, 辛國華, 侯繼申, 等.肺切除術后支氣管胸膜瘺的外科治療.江蘇醫藥, 2012, 38(6):725-726.
27. Tayama K, Eriguchi N, Futamata Y, et al.Modified Dumon stent for the treatment of a bronchopleural fistula after pnumonectomy.Ann Thorac Surg, 2003, 75(1):290-292.
28. Ishikawa K, Kato T, Aragaki M, et al.Endobronchial closure of a bronchopleural fistula using a fibrin glue-coated collagen patch and fibrin glue.Ann Thorac Cardiovasc Surg, 2013, 19(6):423-427.
29. Wright CD, Wain JC, Mathisen DJ, et al.Postpneumonectomy bronchopleural fistula after sutured bronchial closure:Incidence, risk factors and management.J Thorac Cardiovasc Surg, 1996, 112(5):1367-1371.
30. 王斌, 李金東, 張興義, 等.自體帶蒂組織修補肺切除術后支氣管胸膜瘺.中國現代藥物應用, 2013, 7(14):68-69.
31. 張真銘, 王允.肺癌術后支氣管胸膜瘺致死性大咯血經驗.中國肺癌雜志, 2012, 15(1):39-43.
32. 羅清泉, 趙曉菁, 周允中, 等.肺癌全肺切除術后支氣管胸膜瘺的原因分析和處理.中國癌癥雜志, 2003, 13(4):373-375.
33. Bédard EL, Uy K, Keshavjee S.Postpneumonectomy syndrome:a spectrum of clinical presentations.Ann Thorac Surg, 2007, 83(3):1185-1188.
34. Lloyd MS, Wallis C, Muthialu N, et al.Treatment of postpneumo-nectomy syndrome with tissue expanders:the Great Ormond Street Hospital experience.J Plast Reconstr Aesthet Surg, 2014, 67(5):725-728.
35. Valji AM, Maziak DE, Shamji FM, et al.Postpneumonectomy synd-rome recognition and management.Chest, 1998, 114(6):1766-1769.
36. Choi L, LaQuaglia PM, Cordeiro GP.Prevention of postpneumonec-tomy syndrome in children with prophylactic tissue expander insertion.J Pediatr Surg, 2012, 47(7):1354-1357.
37. Zahid I, Routledge T, Billè A, et al.What is the best treatment of postpneumonectomy empyema?Interact Cardiovasc Thorac Surg, 2011, 12(2):260-264.
38. Sharifpour M, Bittner EA.Postpneumonectomy syndrome:a case of shifting priorities.Anesthesiology, 2014, 121(6):1334.
39. Kreisel D, Krupnick AS, Huddleston CB.Outcomes and late complications after pulmonary resections in the pediatric population.Semin Thorac Cardiovasc Surg, 2004, 16(3):215-219.
40. Saatvedt K, Hoel T, Westvik J, et al.Correction of postpneumonec-tomy syndrome in infants with saline-filled expandable prosthesis.Interact Cardiovasc Thorac Surg, 2011, 13(1):89-90.
41. McRae MC, Detterbeck FC, Narayan D.Correction of postpneumo-nectomy syndrome using a custom implant.BMJ Case Rep, 2011.doi:10.1136/bcr.11.2010.3523.
42. Podevin G, Larroquet M, Camby C, et al.Postpneumonectomy syndrome in children:advantages and long-term follow-up of expandable prosthesis.Pediatr Surg, 2001, 36(9):1425-1427.
43. 支修益, 衛生部臨床路徑審核專家委員會胸外科專家組.胸外科圍手術期氣道管理專家共識(2012年版).中國胸心血管外科臨床雜志, 2013, 20(3):251-255.
44. Jablonski S, Brocki M, Klejszmit P, et al.Repair of postpneumonec-tomy bronchopleural fistula using pedicled pericardial flap suppo-rted by fibrin glue.Int Wound J, 2013 Apr 5.doi:10.1111/iwj.12072.
45. Spartalis E, Tomos P, Konofaos P, et al.The effect of autologous platelet-rich plasma on bronchial stump tissue granulation after pneumonectomy:experimental study.ISRN Surg, 2013:864350.
46. Shen RK, Wain CJ, Wright DC, et al.Postpneumonectomy syndrome:surgical management and long-term results.J Thorac Cardiovasc Surg, 2008, 135(6):1210-1216.

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