Techniques de pneumonectomie

After more than half a century where pneumonectomy was the only curative procedure for bronchial carcinoma, this intervention has become a procedure to be avoided as far as possible, due to its high associate in-hospital mortality (about 6% to 7% in specialized centers, up to 12% after the 3rd postoperative month)1. A better selection and preparation of the patients and significant technical improvements have stabilized the risk. An increased risk should be predicted however, related to the population ageing and to the more frequent combination of chemo- or radiotherapy with surgery. Any thoracic surgeon should be aware of the strictness of pneumonectomy procedures and rules for adequate decision making, successful surgery performance and management of the postoperative course. In this article, detailed description of pneumonectomy and extrapleural pneumonectomy surgical techniques is provided, together with a presentation of the indications and postoperative management.