HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Yuji Shiraishi Naoya Katsuragi Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Shiraishi, Y. Articles by Takahashi, N. Search for Related Content PubMed PubMed Citation Articles by Shiraishi, Y. Articles by Takahashi, N. Related Collections Lung - other

Ann Thorac Surg 2004;78:399-403
© 2004 The Society of Thoracic Surgeons

---

Original article: general thoracic

Pneumonectomy for nontuberculous mycobacterial infections

^a Section of Chest Surgery, Fukujuji Hospital, Tokyo, Japan

Accepted for publication February 23, 2004.

^* Address reprint requests to Dr Shiraishi, Section of Chest Surgery, Fukujuji Hospital, 3-1-24 Matsuyama, Kiyose, Tokyo, 204-8522 Japan
e-mail: yujishi{at}mvb.biglobe.ne.jp

Presented at the Poster Session of the Fortieth Annual Meeting of The Society of Thoracic Surgeons, San Antonio, TX, Jan 26–28, 2004.

BACKGROUND: Pneumonectomy is considered in the treatment of nontuberculous mycobacterial infections when an entire lung is affected. However, this procedure carries high morbidity. We report on our experience in using pneumonectomy for treating patients with nontuberculous mycobacterial infections.

METHODS: Between 1983 and 2002, 53 patients infected with nontuberculous mycobacteria underwent 55 pulmonary resections. Of these patients, 11 (3 men, 8 women) underwent pneumonectomy (5 right, 6 left). Median age was 57 years (range, 43 to 69 years). Mycobacterium avium complex disease occurred in 10 patients and Mycobacterium abscessus disease in 1. Indications for pneumonectomy included multiple cavities in one lung and destruction of an entire lung. The bronchial stump was covered with a latissimus dorsi muscle flap in 7 patients and with an intercostal pedicle flap in 2.

RESULTS: Operating time ranged from 142 to 477 minutes (median, 360 minutes). The median intraoperative blood loss was 555 mL (range, 130 to 1,245 mL). There was no operative mortality. Bronchopleural fistula occurred in 3 patients. All fistulas were observed after right pneumonectomy, and were treated by reclosure of the bronchus. Empyema occurred in 1 patient, who was treated with irrigation. All patients achieved sputum-negative status after surgery. Two late deaths occurred. One patient died of respiratory failure 11 months after surgery. A second patient, the only patient who had recurrent disease, died of respiratory failure 4 years postoperatively.

CONCLUSIONS: Despite bronchial stump protection, right pneumonectomy carries a risk for bronchopleural fistula. Nonetheless, pneumonectomy can result in high cure rates in patients with nontuberculous mycobacterial infections.

This article has been cited by other articles:

				J. D. Mitchell, A. Bishop, A. Cafaro, M. J. Weyant, and M. Pomerantz Anatomic Lung Resection for Nontuberculous Mycobacterial Disease Ann. Thorac. Surg., June 1, 2008; 85(6): 1887 - 1893. [Abstract] [Full Text] [PDF]

				S. K. Field and R. L. Cowie Lung Disease Due to the More Common Nontuberculous Mycobacteria Chest, June 1, 2006; 129(6): 1653 - 1672. [Abstract] [Full Text] [PDF]

				Y. Shiraishi, N. Katsuragi, Y. Nakajima, M. Hashizume, N. Takahashi, and Y. Miyasaka Pneumonectomy for complex aspergilloma: is it still dangerous? Eur. J. Cardiothorac. Surg., January 1, 2006; 29(1): 9 - 13. [Abstract] [Full Text] [PDF]

				G Price The role of pneumonectomy in non-tuberculous mycobacterial infections Thorax, November 1, 2004; 59(11): 954 - 954. [Full Text] [PDF]