BACKGROUND: Pneumonectomy for nonmalignant disease is unusual. We wondered about the incidence, predisposing risks, and outcomes of this entity.

METHODS: We interrogated the Society of Thoracic Surgeons General Thoracic Surgery Database to compare patients undergoing pneumonectomy for benign or malignant indications between 2006 and 2010.

RESULTS: 309 of 3081 (10%) patients underwent pneumonectomy for nonmalignant conditions. The benign group were younger (56 vs. 62 years), more likely to be on steroid therapy (11.3% vs. 2.7%), and less likely to be current smokers (14.4% vs. 20.1%). Both groups had an equal incidence of comorbidities. Preoperative pulmonary function was decreased in the nonmalignant group: forced expiratory volume in 1 s 61% vs. 74% of predicted; carbon monoxide diffusion in the lung 61% vs. 71% of predicted. The most common nonmalignant etiologies requiring pneumonectomy were lung and pleural infections. The benign group had increased postoperative bleeding, infections, and lung-related complications.

CONCLUSIONS: Approximately 10% of patients undergoing pneumonectomy have nonmalignant disease. In these cases, careful patient selection with detailed preoperative preparation including improvement in nutrition and functional status are indicated. Technical aspects of pneumonectomy, which minimize perioperative bleeding and infectious complications, are particularly important when this surgery is performed for nonmalignant conditions.