Comprehensive analysis of prognostic factors and clinical implications of pneumonectomy for destroyed lung.

BACKGROUND: Evaluate the efficacy and safety of pneumonectomy in the treatment of destroyed lung caused by benign diseases, and identify the risk factors for postoperative complications. METHODS: We retrospectively analyzed 158 patients with destroyed lung caused by benign diseases who underwent pneumonectomy in a single center from January 2014 to December 2024. Cases were assigned to tuberculosis (TB) group and non-tuberculosis (non-TB) group. Clinical characteristics and postoperative complications were analyzed and compared between groups. Univariate and multivariate analyses were performed to investigate the risk factors of pneumonectomy. RESULTS: A total of 125 TB and 33 non-TB patients were included. All patients with preoperative hemoptysis recovered after surgery. Major postoperative complications were observed in 32 patients (20.3%), and perioperative deaths were noted in three patients (1.9%), who were from the TB group. The TB group had a longer duration of surgery and length of stay in the intensive care unit (ICU), a higher proportion of diabetes and postoperative complications (24.0% vs. 6.1%, p = 0.027) than the non-TB group. Multivariate logistic analyses indicated diabetes [odds ratio [OR]: 4.680; 95% confidence interval [CI]: 1.578-13.881; p = 0.005] and duration of surgery (OR: 1.005; 95% CI: 1.001-1.010; p = 0.036) were the independent risk factors of postoperative complications of pneumonectomy. CONCLUSION: Pneumonectomy is effective for destroyed lung caused by benign diseases. Patients with TB destroyed lung have a higher risk of postoperative complications. Controlling perioperative blood glucose and reducing duration of surgery may reduce the risk of perioperative complications.