AN AUDIT OF LOBECTOMY FOR PULMONARY DISEASE AT LADY READING HOSPITAL, PESHAWAR

Authors

  • Asif Nadeem
  • Amir Bilal
  • Sharifullah Jan

Abstract

Background: The present study was designed to provide data on the role of elective open lobectomies in the treatment of benign and malignant pulmonary diseases in our setting. Methods: An audit of patients’ records over a two-year period was performed to collect relevant data at the Cardio Thoracic Unit of the Lady Reading Hospital Peshawar Pakistan. Results: A total of 55 lobectomies were performed from January 1999 to December 2000, including 34 males and 21 females. The mean age of patients was 31.23 ± 14.95 years, with only 7 (12.7%) cases above 50 years of age. Benign pulmonary conditions, particularly chronic lung infections were the major indication for lobectomies (50/55, 90.9%), while lung cancers accounted for only 5/55 (9.1%) of lobectomies. Bronchiectasis was the leading indication with 28 (50.9%) lobectomy cases. Most patients (37/55, 67.3%) had uneventful postoperative recovery, while 18/55 (32.7%) developed some sort of complication. The most common postoperative complication was infection (wound infection and empyema) accounting for 8 patients (14.6%), followed by air leak (5/55, 9.1%). Mortality was low, with only 2 deaths (3.6%). Conclusion: Elective open lobectomy is a safe procedure in our setting with significant benefits for patients and acceptable morbidity and mortality.Key Words: Lobectomy, Chronic Lung Infection, VATS, Air Leak, Bronchiectasis. 

References

Tuffier T. De la resection du sommet du poumon. Semin Med Paris 1891;2:202.

Kittle CF. The history of lobectomy and segmentectomy including sleeve resection. Chest Surg Clin N Am. 2000 Feb;10(1):105-30, ix.

Weber A, Stammberger U, Inci I, Schmid RA, Dutly A, Weder W. Thoracoscopic lobectomy for benign disease – a single centre study on 64 cases. Eur J Cardiothorac Surg 2001;20:443-448.

The role of surgery in lung cancer treatment. Lobe and Lung Removal: Lobectomy and Pneumonectomy. Available from: http://www.treatments-for-lung-cancer.com/html/surgery.php3. Accessed July 6, 2003, Last modified June 23, 2003.

Yim APC. VATS major pulmonary resection revisited—controversies, techniques, and results. Ann Thorac Surg 2002;74:615-623.

Keagy BA, Lores ME, Starek PJ, Murray GF, Lucas CL, Wilcox BR. Elective pulmonary lobectomy: factors associated with morbidity and operative mortality. Ann Thorac Surg. 1985 Oct;40(4):349-52.

Stephan F, Boucheseiche S, Hollande J, Flahault A, Cheffi A, Bazelly B,Bonnet F. Pulmonary Complications Following Lung Resection. A Comprehensive Analysis of Incidence and Possible Risk Factors. Chest Nov 2000;118 (5): 1263 - 70

Venuta F, Rendina EA, De Giacomo T, Flaishman I, Guarino E, Ciccone AM, Ricci C. Technique to reduce air leaks after pulmonary lobectomy. Eur J Cardiothorac Surg. 1998 Apr;13(4):361-4.

Korst RJ, Humphrey CB. Complete lobar collapse following pulmonary lobectomy. Its incidence, predisposing factors, and clinical ramifications. Chest. 1997 May;111(5):1285-9.

Nakata M, Saeki H, Yokoyama N, Kurita A, Takiyama W, Takashima S. Pulmonary function after lobectomy: video-assisted thoracic surgery versus thoracotomy. Ann Thorac Surg 2000;70:938-941.

Solaini L, Prusciano F, Bagioni P, Di Francesco F, Basilio Poddie D. Video-assisted thoracic surgery major pulmonary resections. Present experience. Eur J Cardiothorac Surg. 2001 Sep;20(3):437-42.

Keagy BA, Lores ME, Starek PJ, Murray GF, Lucas CL, Wilcox BR. Elective pulmonary lobectomy: factors associated with morbidity and operative mortality. Ann Thorac Surg. 1985 Oct;40(4):349-52.

Abolhoda A, Liu D, Brooks A, Burt M. Prolonged air leak following radical upper lobectomy: an analysis of incidence and possible risk factors. Chest 1998;113:1507-10.

Marshall, MB, Deeb ME, Bleier JIS, Kucharczuk JC, Friedberg JS, Kaiser LR, Shrager JB. Suction vs Water Seal After Pulmonary Resection - A Randomized Prospective Study. Chest 2002;121:831-835.

Venuta F, Rendina EA, De Giacomo T, Flaishman I, Guarino E, Ciccone AM, Ricci C. Technique to reduce air leaks after pulmonary lobectomy. Eur J Cardiothorac Surg. 1998 Apr;13(4):361-4.

Rovera F, Imperatori A, Militello P, Morri A, Antonini C, Dionigi G, Dominioni L. Infections in 346 Consecutive Video-Assisted Thoraco-scopic Procedures. Surg Infect 2003;4(1):45-51.