Principles of posterolateral thoracotomy and pneumonectomy

Pneumonectomy is a surgical procedure to remove whole lung and usually performed by posterolateral thoracotomy. It can also be performed by video-assisted thoracoscopic surgery (VATS). Pneumonectomy is indicated where curative surgical resection is not possible with lesser resection. Prior to pneumonectomy a thorough preoperative assessment of the patient is performed as per British Thoracic Society guidelines. This procedure leads to considerable reduction in respiratory reserve of the patient and is also associated with significant morbidity and mortality. Common complications include arrhythmias, myocardial infarction, pulmonary embolism, pneumonia, empyema, respiratory failure and bronchopleural fistula. The perioperative mortality rate ranges between 6% and 8%. Very dedicated and careful postoperative management is required in specialized centres to avoid complications.