Because of the substantial sudden loss in cardiopulmonary reserve on top of chronic reductions by underlying diseases or other cancer therapies, pneumonectomy complications are common. Minimally invasive approaches and improvements in perioperative care that have reduced morbidities and mortalities for other high-risk oncologic procedures have had less impact on this operation. Lung sparing procedures are preferred, but pneumonectomy is occasionally the only reasonable oncologic option. Surgeons need to be familiar with the techniques available to avoid and, if necessary, treat resultant complications that are exaggerated by vacant thoracic space.
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