Clinical characteristics and postoperative quality of life analysis in pediatric unilateral total pneumonectomy.

PURPOSE: To evaluate the safety and feasibility of unilateral total pneumonectomy in pediatric patients and analyze postoperative quality of life outcomes.

METHODS

A retrospective analysis was conducted on 10 pediatric patients who underwent unilateral total pneumonectomy between January 2018 and October 2024. Clinical characteristics, intraoperative parameters, and complications were recorded. Cardiopulmonary function was assessed preoperatively and at 3, 6, and 12 months postoperatively using spirometry and echocardiography. Quality of life was evaluated using the PedsQL 4.0 questionnaire at 1-year follow-up.

RESULTS

The cohort included congenital pulmonary malformations (n=6) and neoplastic diseases (n=4). Seven patients underwent thoracoscopic surgery and three had open procedures. No intraoperative complications or perioperative mortality occurred. Mean operative time was 230±76 minutes with minimal blood loss. Pulmonary function significantly declined at 3 months but recovered to 60–80% of baseline by 12 months. Cardiac function remained stable throughout. Quality of life was moderately high, though physical and emotional domains showed greater impairment compared to social and academic functioning.

CONCLUSION

Unilateral total pneumonectomy is safe and feasible in carefully selected pediatric patients, with minimal perioperative morbidity. Despite significant initial decline, pulmonary function demonstrates satisfactory compensation within one year, and most patients achieve moderately high quality of life, supporting the procedure’s utility in pediatric thoracic surgery.