Even in the early days of thoracic surgery, pneumonectomy held a special position, as the procedure had a 100 percent mortality rate. It was not until 1931 that the first documented successful pneumonectomy in a child after thoracic trauma was performed by Rudolph Nissen.
Since then, not only surgical techniques but also anesthesia and intensive care medicine have significantly advanced. Nevertheless, the procedure remains an operation with considerable risks, a 30-day mortality rate of 5% to 12%, and a lifelong reduction in quality of life. Strict indication and selection of patients for the procedure is the most important factor. (3, 4)
Considering the mostly malignant indication of advanced bronchial carcinoma, patients were predominantly grateful for the gained lifetime despite significant physical limitations. (5)
It is therefore always necessary to check whether a parenchyma-sparing sleeve resection is possible. Current literature shows that a sleeve lobectomy ("sleeve resection") is associated with a significantly lower 30-day mortality rate between 0 and 4.3%. (6) Postoperative lung function and thus physical resilience are also significantly improved, which logically explains an increased quality of life. (5, 6)
The original concerns about an increased rate of local recurrences have been clearly refuted by newer studies, provided that intraoperative frozen section diagnostics and strict indication are considered. (7)