Our Summary

This research paper discusses a medical procedure known as pneumonectomy, which is the removal of a lung. This is often done after a traumatic lung injury. The paper examines whether the mortality rate for this procedure has improved over time. The researchers compared pneumonectomy (removal of a whole lung) to limited lung resections (removal of a portion of a lung) in terms of mortality rates. They used data from the Trauma Quality Improvement Program from 2010 to 2016 and performed statistical analyses.

They found that of over 287,000 patients with traumatic lung injuries, only 889 required lung removal. Of these, 85.3% underwent limited lung resections and 14.7% underwent pneumonectomy. Patients who had their whole lung removed had a slightly higher injury severity score, but there was no difference in their initial blood pressure compared to those who had only a part of their lung removed.

However, the mortality rate was significantly higher for patients who had their entire lung removed compared to those who only had a part of their lung removed (64.9% versus 27.2%). In fact, having a pneumonectomy was the strongest predictor of death, increasing the odds of mortality by almost five times compared to limited lung resections.

The researchers suggest that future studies should explore ways to improve survival rates after pneumonectomy. They also recommend that doctors should consider pneumonectomy as a last resort due to its high mortality rate.

FAQs

  1. What is a pneumonectomy and why might it be necessary?
  2. How does the mortality rate compare between patients who have a pneumonectomy and those who undergo limited lung resections?
  3. Why do the researchers recommend considering pneumonectomy as a last resort?

Doctor’s Tip

A doctor might advise a patient undergoing lung resection to quit smoking and improve their overall lung health through regular exercise and a healthy diet to optimize their recovery and reduce the risk of complications.

Suitable For

Patients who are typically recommended lung resection are those with traumatic lung injuries that cannot be managed with conservative treatment methods. This includes patients with severe lung damage, such as extensive lacerations, contusions, or hematomas, that cannot be repaired or treated effectively without surgical intervention. Additionally, patients with lung cancer or other lung diseases that have not responded to other treatments may also be recommended for lung resection. It is important for patients to be evaluated by a multidisciplinary team of healthcare professionals, including surgeons, pulmonologists, and oncologists, to determine the most appropriate treatment plan for their specific condition.

Timeline

  • Before lung resection: The patient experiences a traumatic lung injury that requires medical intervention. They may undergo diagnostic tests such as imaging scans to determine the extent of the injury. If it is determined that a lung resection is necessary, the patient will undergo preoperative evaluations and preparations. This may include discussions with the surgical team, anesthesia consultations, and preoperative testing to assess the patient’s overall health and fitness for surgery.

  • The day of lung resection: The patient will be admitted to the hospital and prepared for surgery. They will undergo general anesthesia and the surgical team will perform the lung resection procedure, either removing a portion of the lung (limited lung resection) or the entire lung (pneumonectomy). The surgery can take several hours and the patient will be closely monitored throughout the procedure.

  • After lung resection: The patient will be transferred to the intensive care unit (ICU) for postoperative care and monitoring. They may require a ventilator to assist with breathing and will be closely monitored for any complications such as bleeding, infection, or respiratory issues. The patient will also receive pain management and physical therapy to aid in recovery. Once stable, the patient will be transferred to a regular hospital room for further monitoring and rehabilitation.

  • Recovery and follow-up: The patient will undergo a period of recovery in the hospital before being discharged. They will receive instructions on wound care, pain management, and respiratory exercises to aid in their recovery. Follow-up appointments will be scheduled to monitor the patient’s progress and address any concerns or complications that may arise. Physical therapy may also be recommended to help the patient regain strength and lung function.

What to Ask Your Doctor

Some questions a patient should ask their doctor about lung resection include:

  1. What are the potential risks and complications associated with a lung resection?
  2. How will the procedure impact my lung function and overall quality of life?
  3. What is the recovery process like after a lung resection surgery?
  4. Are there any alternative treatment options available to me besides a lung resection?
  5. How many of these procedures have you performed and what is your success rate?
  6. What is the expected outcome of the surgery in terms of improving my condition?
  7. How long will I need to stay in the hospital after the surgery and what is the follow-up care plan?
  8. Are there any lifestyle changes I need to make after the surgery to support my recovery?
  9. How often will I need to follow up with you after the surgery?
  10. What are the long-term implications of having a lung resection in terms of my health and well-being?

Reference

Authors: Homo RL, Grigorian A, Lekawa M, Dolich M, Kuza CM, Doben AR, Gross R, Nahmias J. Journal: Updates Surg. 2020 Jun;72(2):547-553. doi: 10.1007/s13304-020-00727-4. Epub 2020 Feb 21. PMID: 32086773