title: Effect of advanced age on peri-operative outcomes after robotic-assisted pulmonary lobectomy: Retrospective analysis of 287 consecutive cases.
abstract: We investigated whether advanced age affects peri-operative outcomes after robotic-assisted pulmonary lobectomies.
  
  
  
  We retrospectively analyzed patients who underwent robotic-assisted lobectomy by one surgeon over a 5-year period. Rates of postoperative complications were compared according to age group. Other outcomes, such as intraoperative complications, hospital length of stay (LOS), and in-hospital mortality, were also compared.
  
  
  
  A total of 287 patients were included (mean age 67.1yr). Group A had 65 patients of advanced age≥75yr (range 75-87yr; 37 men, 28 women); Group B had 222 patients aged <75yr (range 29-74yr; 95 men, 127 women). Group A had 10/65 (15.4%) patients with robotic-related intraoperative complications, compared to 10/222 (4.5%) for Group B (p=0.002), with the most frequent intraoperative complications being bleeding from a pulmonary vessel (10.8% vs. 4.5%, p=0.06), bronchial injury (3.1% vs. 0.9%, p=0.18), and injury to the phrenic or recurrent laryngeal nerve (1.5% vs. 0.4%, p=0.33). There were 28/65 (43.1%) patients in Group A with postoperative complications compared to 76/222 (34.2%) in Group B (p=0.19). While operative times were similar (p=0.42), Group A had longer median hospital LOS of 6±0.9days compared to 4±0.3days for Group B (p=0.02).
  
  
  
  While younger patients have lower risk of robotic-related intraoperative complications and shorter hospital LOS, elderly patients do not have increased overall or emergent conversion rates to open lobectomy, overall postoperative complications rates, or in-house mortality compared to younger patients. Thus, robotic-assisted pulmonary lobectomy is feasible and relatively safe for patients of advanced age.
authors.affiliation: Morsani College of Medicine, University of South Florida Health, Tampa, FL USA.
authors.forename: Kathryn S
authors.initials: KS
authors.lastname: Kass
authors.affiliation: Department of Surgery, University of South Florida, Health Morsani College of Medicine, Tampa, FL USA.
authors.forename: Frank O
authors.initials: FO
authors.lastname: Velez-Cubian
authors.affiliation: Department of Surgery, University of South Florida, Health Morsani College of Medicine, Tampa, FL USA.
authors.forename: Wei Wei
authors.initials: WW
authors.lastname: Zhang
authors.affiliation: Morsani College of Medicine, University of South Florida Health, Tampa, FL USA.
authors.forename: Kavian
authors.initials: K
authors.lastname: Toosi
authors.affiliation: Department of Thoracic Oncology, Moffitt Cancer Center, Tampa, FL USA; Department of Oncologic Sciences, University of South Florida, Health Morsani College of Medicine, Tampa, FL USA.
authors.forename: Tawee
authors.initials: T
authors.lastname: Tanvetyanon
authors.affiliation: Morsani College of Medicine, University of South Florida Health, Tampa, FL USA.
authors.forename: Kathryn L
authors.initials: KL
authors.lastname: Rodriguez
authors.affiliation: Morsani College of Medicine, University of South Florida Health, Tampa, FL USA.
authors.forename: Matthew R
authors.initials: MR
authors.lastname: Thau
authors.affiliation: Department of Thoracic Oncology, Moffitt Cancer Center, Tampa, FL USA.
authors.forename: Joseph R
authors.initials: JR
authors.lastname: Garrett
authors.affiliation: Department of Thoracic Oncology, Moffitt Cancer Center, Tampa, FL USA.
authors.forename: Carla C
authors.initials: CC
authors.lastname: Moodie
authors.affiliation: Department of Thoracic Oncology, Moffitt Cancer Center, Tampa, FL USA; Department of Surgery, University of South Florida, Health Morsani College of Medicine, Tampa, FL USA; Department of Oncologic Sciences, University of South Florida, Health Morsani College of Medicine, Tampa, FL USA.
authors.forename: Jacques P
authors.initials: JP
authors.lastname: Fontaine
authors.affiliation: Department of Thoracic Oncology, Moffitt Cancer Center, Tampa, FL USA; Department of Surgery, University of South Florida, Health Morsani College of Medicine, Tampa, FL USA; Department of Oncologic Sciences, University of South Florida, Health Morsani College of Medicine, Tampa, FL USA. Electronic address: eric.toloza@moffitt.org.
authors.forename: Eric M
authors.initials: EM
authors.lastname: Toloza
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D015505:Chest Tubes / Q000706:statistics & numerical data; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008137:Longitudinal Studies; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011013:Pneumonectomy / Q000009:adverse effects* / Q000379:methods / Q000401:mortality; D011183:Postoperative Complications / Q000453:epidemiology*; D019106:Postoperative Hemorrhage / Q000453:epidemiology; D012189:Retrospective Studies; D065287:Robotic Surgical Procedures / Q000009:adverse effects*
keywords: Advanced age; Lobectomy; Lung cancer; Robotic; Surgical outcomes