Evaluation of factors affecting morbidity and mortality in pneumonectomy patients.

Background: The aim of this study was to evaluate risk factors associated with morbidity and mortality after pneumonectomy in non-small cell lung cancer patients.
Methods: The study included 107 patients who underwent pneumonectomy for non-small cell lung cancer between January 2013 and December 2018. Prognostic factors affecting mortality and morbidity were investigated.
Results: The patient group included 10 women (9.3%) and 97 men (90.7%) with a mean age of 59.5 ± 8.5 years. Seventy-three patients (68.2%) underwent standard pneumonectomy and 34 (31.8%) underwent extended pneumonectomy. Nine patients (8.4%) received induction chemotherapy. Complications occurred in 33 patients (30.8%). Complications were classified as surgical, cardiovascular, pulmonary, or infectious. Charlson Comorbidity Index (CCI) > 3 and right-side resection were significant risk factors for the development of complications. The most common complication was atrial fibrillation. Eleven patients developed a bronchopleural fistula. The 30-day postoperative mortality rate was 6.5% ( n  = 7). Mortality was not associated with any demographic and surgical characteristics other than CCI > 3 ( p  = .05).
Conclusion: The results of this study indicate that our pneumonectomy outcomes are acceptable despite high morbidity and mortality rates. Appropriate patient selection for pneumonectomy is as important as complication management. High-comorbidity patients should undergo these procedures in experienced centers.