Indications for pneumonectomy. Pneumonectomy for benign disease.

A wide variety of nonmalignant diseases of the lung require pneumonectomy. Pneumonectomy for inflammatory lung disease is frequently associated with high morbidity rates, and the frequencies of postpneumonectomy space empyema and bronchopleural fistula are high. It is essential to treat underlying infections prior to surgery in an effort to minimize the sputum production, maximize the patient's nutritional status, minimize the chance for intraoperative spillage, and decrease the risk of postoperative bronchopleural fistulas and postpneumonectomy space empyemas. Despite the challenges of performing a pneumonectomy for inflammatory diseases, cure rates for MDR-TB, MOTT infections, and fungal disease, including invasive fungal disease, are excellent. Pneumonectomy for trauma is associated with very high mortality, and efforts should be made to avoid pneumonectomy if possible. Pneumonectomy for other benign conditions is unusual.