Pneumonectomy: review of 351 cases.

Among 351 patients undergoing pneumonectomy, the mortality was 6%, and when the operation was performed for malignant disease, the mortality was 8.5%. Much of the risk of the operation is associated with the age, physiologic state, and associated diseases which are prevalent in patients who require pneumonectomy. The conduct of the operative procedure itself is of paramount importance since complications clearly increase the mortality. Operative mishaps predispose to postoperative complications, and the addition of postoperative problems to the operative complications combine to bring the mortality to 24%. Careful hemostasis, meticulous technique, fluid and blood replacement, as well as careful preoperative and postoperative management combine to produce an acceptable mortality in this serious procedure.