Background: The treatment of secondary pneumothorax in elderly patients is difficult because of underlying diffuse lung injury and complex medical comorbidities. Such patients still have high morbidity rates, resulting in longer periods of hospitalization. Methods: To examine the results of video-assisted thoracic surgery for elderly patients (aged 70 years or over) with secondary pneumothorax and investigate the risk factors for hospital stay longer than 7 days, we retrospectively analyzed the results obtained in such patients at our institution. Results: From among 73 patients who entered this study, 7 patients (9.6%) had postoperative complications. Video-assisted thoracic surgery could treat pneumothorax in 71 patients, except for the 2 who died in hospital. The median postoperative drainage and hospital stay periods were 2 days (1-40 days) and 5 days (2-51 days). Patients with interstitial pneumonitis, pulmonary infection and low total protein or sodium levels were the risk factors for hospital stay longer than 7 days. Conclusions: VATS is a safe and effective procedure for secondary pneumothorax in elderly patients. Patients with interstitial pneumonitis, pulmonary infection, and hyponutrition state were the risk factors for postoperative hospital stay prolongation.

Purpose: Surgical treatment of lung cancer in patients receiving hemodialysis carries a high risk because of poor cardiac function and a fragile electrolyte balance. Because the number of patients receiving hemodialysis has increased, the proportion of such patients with lung cancer is expected to rise. However, few studies have examined the results of surgery for lung cancer in hemodialysis patients, especially by video-assisted thoracoscopic surgery (VATS). Methods: We conducted a retrospective analysis of 5 hemodialysis patients who underwent VATS for lung cancer. Results: All patients were men, and the mean age was 70.4 years. The operative procedure was lobectomy in 4 patients and segmentectomy in 1. During the perioperative period, none required urgent hemodialysis. There were no critical complications and in-hospital deaths. Three of the 5 patients are currently alive and recurrence-free. One patient died of recurrence at 4 month after surgery, and the other patient died at 17 months after surgery without cancer recurrence.Conclusions: VATS appears to be a safe procedure for hemodialysis patients with lung cancer, and the long-term outcome is satisfactory.Keywords: hemodialysis, lung cancer, video-assisted thoracic surgery IntroductionBecause the number of patients receiving hemodialysis has increased, a proportionate increase of such patients with lung cancer is expected, and therefore surgical resection of lung cancer in this patient population would undoubtedly increase. However, few previous studies have analyzed the results of surgery for lung cancer in hemodialysis patients.Hemodialysis patients who undergo surgery represent a high-risk group requiring careful perioperative management to avoid electrolyte imbalance and hemodynamic instability. In such patients, damage to the chest wall muscles may lead to an increase in the blood levels of creatinine and potassium after surgery. Unlike thoracotomy, video-assisted thoracoscopic surgery (VATS) creates less chest wall damage. Therefore, VATS may be advantageous for treatment of lung cancer in hemodialysis patients.Here we report 5 hemodialysis patients with lung cancer who underwent lobectomy or segmentectomy using VATS, and suffered no severe complications or mortality. Patients and MethodsBetween January 2006 and December 2008, 5 lung cancer patients who were receiving hemodialysis underwent resection of their cancers using VATS at our institution. In the same periods, we have no patients Ann Thorac Cardiovasc Surg Vol. 19, No. 4 (2013) 263Ann Thorac Cardiovasc Surg 2013; 19: 263-267 Original ArticleOnline November 15, 2012 doi: 10.5761/atcs.oa.12.01973 Video-Assisted Thoracoscopic Surgery for Lung Cancer in Patients on HemodialysisKatsunari Matsuoka, MD, Ayumi Kuroda, MD, Angyoung Kang, MD, Naoko Imanishi, MD, Shinjiro Nagai, MD, Mitsuhiro Ueda, MD, and Yoshihiro Miyamoto, MD Purpose: Surgical treatment of lung cancer in patients receiving hemodialysis carries a high risk because of poor cardiac function and a fragile electrolyte balance. Because...

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