Clinical Outcomes of Pulmonary Resections for Benign Lung Diseases in Adults

Abstract

Benign lung diseases (BLD) are a spectrum of diseases that require medical and surgical attention. Surgical treatment in majority cases provides curative treatment in majority of the cases. Objective:  To assess the clinical outcome in patients who undergo pulmonary resection for various indications in BLD. Methods: A prospective study was conducted in The Department of Thoracic surgery at Jinnah Postgraduate Medical Center, Karachi from June 2021 to June 2022. All symptomatic patients above the age of 12 years with radiological evidence of resectable lung disease with good cardiopulmonary reserve were included. Results: Eighty-four patients were included; sixty-six (78.6%) were males. Most common indication for resection was bronchiectasis (n=32; 38.1%) and aspergilloma (n=22; 26.2%). Majority of the patients presented with productive cough (44; 52.3%), chest pain (41; 48.8%) and hemoptysis (28;33%). Eighteen (81.8%) out of 22 patients of aspergilloma were complex in nature. Lobectomy (67; 78.8%) was most commonly performed followed by wedge resection (10; 11.7%). Forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) both were significantly improved after lung resection (p˂0.001). The most common complications were post resection fluid (n=12; 14.2%), residual pleural space (n=10;11.9%). Three patients (3.6%) died; two (2.38%) due to respiratory failure and one (1.2%) after myocardial infraction. Conclusions: Despite limitations, lobectomy and lesser pulmonary resections are safe procedures when patients are carefully selected and prepared. Management in a dedicated Thoracic Surgical unit is essential to keep the complication rate under control and patients should be assessed for symptomatic (spirometric) and radiological improvement on follow up visits to document ongoing clinical improvement for an improved quality of life