title: Video-assisted lobectomy in elderly lung cancer patients.
abstract: OBJECTIVE
  We evaluated the pre-, intra- and postoperative outcome of video-assisted thoracic surgery lobectomy in elderly lung cancer patients to determine what factors may be disadvantageous.
  
  
  METHODS
  From June 1982 to May 2000, 707 patients underwent pulmonary resection for primary lung cancer. Of these, 87 patients with t1-2 peripheral lung cancer underwent lobectomy and postoperative pulmonary function tests and postoperative conditions at an average of 2.3 months postoperatively. Of these, 52 underwent video-assisted thoracic surgery lobectomy since 1994 and 35 lobectomy by standard thoracotomy.
  
  
  RESULTS
  Video-assisted thoracic surgery lobectomy offered advantages in blood loss, chest wall damage, and minimal performance deterioration status. The percent vital capacity, percent forced expiratory in 1 second, and percent maximum ventilatory volume were well preserved in patients who underwent video-assisted thoracic surgery lobectomy. Multivariate logistic regression analysis identified operation duration as an independent risk factor in morbidity and operative procedure as an independent risk factor in performance deterioration. In stage IA and IB patients, 3-year-survival was 92.9% and 5-year survival 53.8% in those undergoing lobectomy by standard thoracotomy and 84.2% at 3 years and 60.1% at 5-years in those undergoing video-assisted thoracic surgery lobectomy.
  
  
  CONCLUSIONS
  We thus consider video-assisted thoracic surgery lobectomy in this age group to be an effective procedure, but the long surgical duration is a risk factor in a poor clinical outcome.
authors.affiliation: Department of Surgery II, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8602, Japan.
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Koizumi
authors.forename: Shuji
authors.initials: S
authors.lastname: Haraguchi
authors.forename: Tomomi
authors.initials: T
authors.lastname: Hirata
authors.forename: Kyoji
authors.initials: K
authors.lastname: Hirai
authors.forename: Iwao
authors.initials: I
authors.lastname: Mikami
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Fukushima
authors.forename: Hirotoshi
authors.initials: H
authors.lastname: Kubokura
authors.forename: Daisuke
authors.initials: D
authors.lastname: Okada
authors.forename: Hirohiko
authors.initials: H
authors.lastname: Akiyama
authors.forename: Shigeo
authors.initials: S
authors.lastname: Tanaka
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008168:Lung / Q000503:physiopathology*; D008175:Lung Neoplasms / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D015999:Multivariate Analysis; D011013:Pneumonectomy / Q000379:methods*; D012129:Respiratory Function Tests; D012189:Retrospective Studies; D015996:Survival Rate; D020775:Thoracic Surgery, Video-Assisted; D016896:Treatment Outcome