LUNG RESECTIONS IN THE AGED: WHICH ARE THE LIMITS

Abstract

Introduction: A progressive and constant increase of mean life duration in the last century has determined the chal lenge of the treatment of lung cancer even in the elderly with good functional status. The aim of the present study is to evaluate the results obtained in the elderly, over seventy years old, who underwent pulmonary resection at our Division of Thoracic Surgery of Polyclinic of Bari from 1985 to 1995.

Patients and methods: 938 patients with NSCLC have been operated on, from January 1985 to December 1995. 189 were over seventy and 19 were over eighty years old. We have performed the following surgical procedures: 21 pneumoneotomies, 108 lobectomies/bilobectomies, 44 wedge resections, 16 staging thoracotomies.

Results: Post-operative complications were as follows: ate leatasis 57, air leak 37, empyema 9, broncho-plcural fistu la 3, aritmia 103, pulmonary edema 8, cardiac ischemia 3, pulmonary embolia 1, delirium 2, emothorax 3, exitus 5. There were 3 deatUs caused by acute myocardial ische mia, one by pulmonary embolia, one by main right bron chus broncho-pleural fistula. Two and five-year overall sur vival were 671 and 378, respectively.

Conclusion: Diagnostic and therapeutical procedures for lung cancer should be different in the elderly. In our expe rience, main post-operative complications were cardiovascu lar, consequent to the entity and duration of surgical ope ration and intra-operative blood leaks. The elderly require a more careful post-operative monitoring to prevent this kind of complications.