Abstract
Completion pnrumonectomy (CP) after initial operation for primary lung cancer was performed in 11 patients (5 with metastatic lung cancer, 3 with secondary primary lung carcinoma, 3 with lung abscess: two aspergillosis, one MRSA). All patients underwent radical lobectomy at the first operation. Among the 11 patients, there were no operative or hospital death, and also no major complications during the hospital stay. When CP is required, its radicality and the need to preserve residual respiratory function and cardiac function (FEV1.0 more than 450ml/m2 and %VC more than 35%, total pulmonary vascular resistance at the unilateral pulmonary artery occlusion test less than 600 dyne.sec.cm-5/m2) must be considered in making the decision to undergo CP. In cases where residual lung and the hilar structures showed severe adhesion, it is often prudent to consider the median sternotomy for CP. By using this approach, the pulmonary vessels are easily ligated intrapericardially, the bronchus can be transected as close to the trachea bifurcation as possible, and the stump often was reinforced with viable tissue such as pleura or percardial fat. The five-year survival rate after CP for 11 patients was 37.5% according to the Kaplan-Meier method.
