Outcomes of video‐assisted thoracoscopic surgery lobectomy in septuagenarians

Abstract

Background: Spread of technology and increased surveillance have led to more patients with lung cancers being identified than ever before. Increasingly, patients from the elderly population are referred for surgery; however, many studies do not focus on this patient group. We reviewed the outcomes of septuagenarians who underwent lobectomy via an open thoracotomy (OT) or video-assisted thoracoscopic surgery (VATS) approach to determine whether the VATS approach would result in superior post-operative outcomes. Methods: Between January 2010 and June 2016, a total of 96 patients aged 70 years or older underwent a lobectomy for non-small cell lung carcinoma. Patients who underwent resection for metastatic disease, small cell lung cancer or neuroendocrine tumour were excluded. Demographic details, early and late post-operative outcomes including postoperative arrhythmia, myocardial infarction, respiratory failure, cerebrovascular events, infection, prolonged air leak, delirium, readmission and 30-day mortality were studied. Mean follow-up duration was 23 AE 19.1 months. Results: Seventy-five patients underwent lobectomy via a VATS approach and 21 patients underwent lobectomy via an OT approach. There was no 30-day mortality and no difference in overall survival between the two techniques (P = 0.25). There was no significant difference between the two techniques with regard to post-operative stroke, myocardial infarction, atrial fibrillation, pneumonia, delirium or bronchopleural fistula. VATS patients had a significantly shorter mean hospital length of stay (VATS 4.7 days, OT 9.3 days, P = 0.005). Conclusion: Septuagenarians with non-small cell lung carcinoma can successfully undergo curative lung resection with a low incidence of post-operative complications.© 2020 Royal Australasian College of Surgeons ANZ J Surg 90 (2020) 752-756ANZJSurg.com

Prolonged air leak following video-assisted thoracoscopic major lung resection: newer avenues to manage an age-old problem

“…Pioneers have suggested various approaches like "fissure less" dissection, using either posterior or anterior approach towards the hilum to minimise air leak. Our unit routinely uses anterior approach (hilum first, fissure last) for the VATS, but still PAL is well-known post-operative morbidity (24%), which in turn is responsible for 16% of the patients being discharged from the hospital with chest tube in situ, and it encouraged us to present this mini review on this problem [4].…”

Short-and long-term outcomes of video-assisted thoracoscopic lobectomy in elderly patients with non-small-cell lung cancer

“…However, there are few studies on VATS lobectomy in elderly NSCLC patients, and majority of them only report short-term outcomes [29][30][31][32][33][34][35][36][37]. This study aimed to compare the e cacy of VATS lobectomy in elderly versus non-elderly NSCLC patients in order to explore the short-and long-term outcomes of VATS lobectomy in elderly NSCLC patients.…”