Mortality, complications and loss of pulmonary function after pneumonectomy vs. sleeve lobectomy in patients younger and older than 70 years.
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.
Melloul
Emanuel
E
Division of Thoracic and Vascular Surgery, Centre Hospitalier Universitaire Vaudois, 1011 Lausanne, Switzerland.
Egger
Bernhard
B
Krueger
Thorsten
T
Cheng
Cai
C
Mithieux
Francois
F
Ruffieux
Christiane
C
Magnusson
Lennart
L
Ris
Hans-Beat
HB
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