Pneumonectomy

Excerpt

Lung cancer ranks as the third most common cancer in the United States and the United Kingdom, with over 200,000 and 47,000 new cases diagnosed annually, respectively.[United States (US) Centers for Disease Control and Prevention (CDC) Lung Cancer]. While most patients with lung cancer are treated with lobectomy, recent evidence supports the use of sublobar anatomical resections in some instances. However, more complex surgical procedures, such as sleeve lobectomy or pneumonectomy, remain necessary for patients with central or locally advanced tumors requiring complete resection. In recent years, although there has been a decline in the rate of pneumonectomies performed, this procedure remains essential for specific patients, despite the higher perioperative mortality rate compared to lobectomy or bilobectomy. Nonetheless, for some individuals with central or locally advanced tumors, pneumonectomy remains the only surgical option capable of achieving complete resection.

Pneumonectomy involves the removal of an entire lung and is a crucial option in the management of advanced and complex thoracic diseases. Extrapleural pneumonectomy is an expanded variant of this procedure, encompassing the resection of parietal and visceral pleura, ipsilateral hemidiaphragm, pericardium, and mediastinal lymph nodes, typically for advanced malignancies and often paired with chemotherapy and radiation to improve survival outcomes. The lungs are highly dynamic and responsible for gas exchange, enzyme production, and immune defense, making their removal a significant physiologic challenge. First performed in 1933 by Evarts A Graham for lung carcinoma, pneumonectomy has evolved in scope and technique over the decades. The procedure is now integral in treating malignant and benign lung pathology cases where lung-sparing alternatives are inadequate.