Selection and preoperative treatment of over-seventy-year-old patients undergoing thoracotomy

The thoracic surgeon is confronted with the question of the operability of patients over 70 years old more and more frequently. Not only the advanced age, but also probable functional impairments are decisive for the outcome of an operation in this often polymorbid age group. Fifty-three patients over 70 years old underwent 58 thoracotomies. The hospital lethality was 7.5%, the complication rate 17%. These results could be obtained by a specific selection of patients, based on functional parameters, intensive preoperative medical and physiotherapeutic treatment in terms of improvement of possible functional deficits and the usual postoperative intensive care. In our long-term observations we could record a 5-year survival rate of 100% in patients with benign diseases and of 46% in cases of bronchial carcinoma. These results confirm our attitude that the age 70 years and older should not be considered as contraindication for thoracic surgery.