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Thoracotomy in patients over 70 years old
J Zapatero1, J Flandes, S Salvatierra
1Thoracic Surgery Department, Hospital Ramón y Cajal, Madrid, Spain.
Summary
Elderly patients (70+ years) undergoing thoracic surgery face higher risks but have a low 4% mortality rate. Surgical intervention is feasible, with 26% surviving 5 years for bronchial cancer.
Area of Science:
- Thoracic surgery
- Geriatric medicine
- Oncology
Background:
- Elderly patients (70+ years) present unique challenges for thoracic surgery.
- Surgical intervention for thoracic pathologies in this age group requires careful consideration due to increased operative risk.
Purpose of the Study:
- To evaluate the outcomes of surgical intervention for thoracic pathologies in patients aged 70 years and older.
- To determine the feasibility and safety of thoracic surgery in the elderly population.
Main Methods:
- Retrospective review of 100 patients aged 70+ who underwent thoracic surgery between 1981 and 1990.
- Analysis of patient demographics, pathologies, surgical procedures, complications, mortality, and survival rates.
Main Results:
- The mean age of patients was 73 years, with bronchial cancer being the most frequent diagnosis (55%).
- Postoperative complication rates were higher than average, but overall mortality was low at 4%.
- For bronchial cancer patients, 2-year survival was 66%, 3-year survival was 50%, and 5-year survival was 26%.
Conclusions:
- Thoracic surgery is theoretically not contraindicated in patients aged 70 years and older.
- A systematic and conservative approach is recommended for this high-risk patient group.
- While postoperative morbidity increases, surgical intervention can yield favorable survival outcomes, particularly for bronchial cancer.