Postoperative complications in elderly patients after lung cancer surgery

The purpose of this study was to identify the risk factors for postoperative complications in elderly patients undergoing lung cancer surgery. These complications remain higher in elderly patients than in young patients, and decreasing their incidence is an important goal. We investigated surgical factors in particular, including surgical time, blood loss and thoracotomy length.

Between January 2000 and September 2009, 567 patients underwent lung cancer surgery at our institution. We retrospectively reviewed the records of 119 patients who underwent lobectomy, aged 75 years or older, for possible postoperative complication risk factors.

The patients' median age was 77 years (range, 75-88 years); there were 79 men and 40 women. There were no perioperative or postoperative deaths. Postoperative complications developed in 41 (34.5%) patients, including 17 (14.3%) with arrhythmia, 10 (8.4%) with prolonged air leak, 10 (8.4%) with delirium, 8 (6.7%) with pneumonia, 4 (3.4%) with hypoxia, 2 (1.7%) with cerebrovascular disease and 1 (0.8%) with postoperative haemorrhage. Univariate analysis showed that the risk factors for postoperative complications consisted of longer surgery time (P = 0.002), blood loss (P = 0.021) and undergoing surgery prior to May 2004 (P = 0.002). Multivariate analysis revealed that surgery time (P = 0.041) and surgery prior to May 2004 (P = 0.008) were independent risk factors for postoperative complications.

This study demonstrates that the quality of surgery is an important factor in determining the risk of postoperative complications. Severe adhesions and lung inflammation are conditions that make lung cancer surgery difficult; a skillful and meticulous surgical technique is required in elderly patients.