Short-term outcomes after thoracoscopic lobectomy in elderly compared to younger patients

: As the population continues to age, more benign and malignant lung lesions requiring surgical intervention are being identified in elderly patients. Historically, advanced age has been used to justify performing wedge resection rather than a lobectomy in elderly patients. The introduction of thoracoscopic surgery has resulted in improved short-term outcomes compared with thoracotomy. The objective of this study is to compare short-term outcomes of thoracoscopic lung resection in elderly patients to that in younger patients.

: A retrospective review was performed of all patients undergoing thoracoscopic anatomic lobectomy without previous chemotherapy or radiation between April 2006 and April 2009. Patient charts were reviewed to determine risk factors, perioperative complications, and length of stay. Student's t test was used for comparison between groups.

: Over the period studied, 86 patients underwent thoracoscopic lobectomy. Forty of them were 70 years or older. Baseline pulmonary function testing showed an average FEV1 of 85% predicted (81% younger vs 90% older, P = nonsignificant). Median chest tube duration was 3 days and median length of stay was 4 days in both groups. The overall incidence of perioperative complications was 21% and was not different in the two groups (20% younger vs 22% older).

: Elderly patients with good baseline pulmonary function tolerate thoracoscopic lobectomy as well as younger patients. Advanced age alone should not be considered a contraindication to lobectomy in the era of thoracoscopy. Elderly patients should be offered lobectomy rather than wedge resection on the basis of the same criteria used in younger patients.