Pneumonectomy for non-small cell lung cancer / 中华胸心血管外科杂志

ABSTRACT

Pneumonectomy is mainly used for central primary bronchogenic carcinoma. In order to remove neoplastic tissue to the maximum, one side of the lung tissue needs to be resected.These results in an increased risk of postoperative complications in pneumonectomy compared to lung function preserved lung surgery. But this does not mean that it is the second best thing to abandon its oncology treatment benefits that are unmatched by other surgical methods in the treatment of lung cancer. We should not judge one surgical approach itself but to maxmize its therapeutic benefit through select suitable patients and practice strict perioperative planning. Preoperatively assess the patient's tumor and lymph node status and surgical resectability, cardiopulmonary function, and select the patients who can benefit the most from the operation; Reduce lung injury caused by anesthesia, avoid nerve damage such as phrenic nerve, recurrent laryngeal nerve, vagus nerve branch, etc., reduce the risk factors of anastomotic healing such as blood supply around the anastomosis. Optimize airway management, ventilator management, fluid management, pain management, nutritional support, cardiopulmonary support, spontaneous cough, early activity and other factors in intraoperative and postoperative management. It may be possible to maximize the benifit of a surgical procedure in oncology treatment while avoiding risks.