Minimal-invasive Approach Reduces Cardiopulmonary Complications in Elderly After Lung Cancer Surgery

Overview

Journal J Thorac Dis

Publisher AME Publishing Company

Specialty Pulmonary Medicine

Date 2020 Jul 10

PMID 32642142

Citations 4

Authors

Mohamed Zaatar

Theresa Stork

Daniel Valdivia

Khaled Mardanzai

Dirk Stefani

Stephane Collaud

Pauline Poellen

Balazs Hegedus

Till Ploenes

Clemens Aigner

Affiliations

Soon will be listed here.

Abstract

Background: The number of elderly patients undergoing lung resection for lung cancer is continuously increasing. This study investigates the risk factors for postoperative complications in elderly lung cancer patients and the role of surgical approach in early postoperative outcome.

Methods: We reviewed all consecutive patients who underwent anatomical resection for early stage T1/2 lung cancer in a curative intent between January 2016 and November 2018 at our institution. Clinical data, postoperative complications, hospital stay and 30- and 90-day mortality were prospectively collected.

Results: A total of 505 (278 male) patients were included. One hundred ninety patients (38%) were ≥70 years of age. Forty-eight percent (n=241) had thoracotomy, 52% (n=264) were operated with video-assisted or robot-assisted thoracoscopy. Major cardiopulmonary complications were observed in 4.2% (n=21) patients. There was no significant difference in major cardiopulmonary complication rate following minimally invasive surgery between patients above or below 70 years of age (4.3% . 2.5%, P=0.47). In contrast, major cardiopulmonary complication rate was significantly higher in elderly thoracotomy patients than in patients below 70 years of age (9.9% . 2.6%, P=0.035). Elderly patients operated minimally invasive had a significantly shorter hospital stay compared to open approach (8.1 . 11.9 days, P<0.0001). Thirty- and 90-day mortality was comparable with 1.4% and 1.5%, respectively.

Conclusions: Pulmonary resection for lung cancer in elderly patients is safe and can be performed with a low morbidity and mortality. However, our results indicate that minimal invasive surgery leads to reduced postoperative complications especially in elderly and should be the preferred approach.

Citing Articles

[Surgery of old people-Thoracic surgery].

Ehrsam J, Aigner C Wien Klin Mag. 2023; 26(3):112-121.

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The nomograms for predicting overall and cancer-specific survival in elderly patients with early-stage lung cancer: A population-based study using SEER database.

Yu G, Liu X, Li Y, Zhang Y, Yan R, Zhu L Front Public Health. 2022; 10:946299.

PMID: 36159305 PMC: 9493218. DOI: 10.3389/fpubh.2022.946299.

Non-Intubated Versus Intubated Video-Assisted Thoracic Surgery in Patients Aged 75 Years and Older: A Propensity Matching Study.

Chen P, Chuang J, Lu T, Hung W, Liao H, Tsai T Front Surg. 2022; 9:880007.

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The pathological oral cavity as a preventable source of postoperative pneumonia in thoracic surgery: a prospective observational study.

Ploenes T, Pollok A, Jockel K, Kampe S, Darwiche K, Taube C J Thorac Dis. 2022; 14(4):822-831.

PMID: 35572897 PMC: 9096288. DOI: 10.21037/jtd-21-1178.

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