title: Mortality, complications and loss of pulmonary function after pneumonectomy vs. sleeve lobectomy in patients younger and older than 70 years.
abstract: Retrospective single institution analysis of all patients undergoing sleeve lobectomy or pneumonectomy between 2000 and 2005. Seventy-eight patients underwent pneumonectomy (65 patients <70 years, 13 patients >70 years) and 69 sleeve lobectomy (50 patients <70 years, 19 patients >70 years). Pre-existing co-morbidity, surgical indication and induction therapy was similarly distributed between treatment by age-groups. In patients <70 years, pneumonectomy and sleeve lobectomy resulted in a 30-day mortality of 3% vs. 0 and an overall complication rate of 26% vs. 44%, respectively. In patients >70 years, pneumonectomy and sleeve lobectomy resulted in a 30-day mortality of 15% vs. 0 and an overall complication rate of 23% vs. 32%. In both age groups, pneumonectomy was associated with more airway complications (NS) and a significantly higher postoperative loss of FEV(1) than sleeve lobectomy (P<0.0001, P<0.03). Age per se did not influence the loss of FEV(1) and DLCO for a given type of resection. Sleeve lobectomy may have a therapeutic advantage over pneumonectomy in the postoperative course of elderly patients.
authors.affiliation: Division of Thoracic and Vascular Surgery, Centre Hospitalier Universitaire Vaudois, 1011 Lausanne, Switzerland.
authors.forename: Emanuel
authors.initials: E
authors.lastname: Melloul
authors.forename: Bernhard
authors.initials: B
authors.lastname: Egger
authors.forename: Thorsten
authors.initials: T
authors.lastname: Krueger
authors.forename: Cai
authors.initials: C
authors.lastname: Cheng
authors.forename: Francois
authors.initials: F
authors.lastname: Mithieux
authors.forename: Christiane
authors.initials: C
authors.lastname: Ruffieux
authors.forename: Lennart
authors.initials: L
authors.lastname: Magnusson
authors.forename: Hans-Beat
authors.initials: HB
authors.lastname: Ris
mesh_terms: D000367:Age Factors; D000368:Aged; D005541:Forced Expiratory Volume; D017052:Hospital Mortality; D006801:Humans; D008168:Lung / Q000503:physiopathology / Q000601:surgery*; D011013:Pneumonectomy / Q000009:adverse effects* / Q000401:mortality; D013510:Pulmonary Surgical Procedures / Q000009:adverse effects* / Q000401:mortality; D012129:Respiratory Function Tests; D012189:Retrospective Studies; D018570:Risk Assessment; D013997:Time Factors; D016896:Treatment Outcome