Aoki T, Yamato Y, Tsuchida M, Watanabe T, Hayashi J, Hirono T
Department of Thoracic and Cardiovascular Surgery, Niigata University School of Medicine, 1-757 Asahimachi-dori, 951-8510, Niigata, Japan.
Eur J Cardiothorac Surg. 2000 Dec;18(6):662-5. doi: 10.1016/s1010-7940(00)00573-x.
The purpose of this study was to analyze the risks associated with pulmonary resection for primary non-small cell lung cancer in octogenarians to help better management in these patients.
We reviewed the outcome in our 35 patients aged 80 years and older who underwent pulmonary resection between 1981 and 1998.
The 5-year survival rate was 39.8%. The operative mortality rate was 0% and the morbidity 60%. There were ten major pulmonary complications, including respiratory insufficiency following bacterial pneumonia and sputum retention. Preoperative arterial pO(2) was significantly lower, A-aDO(2) was significantly higher, and operation time were significantly longer in patients with pulmonary complications after surgical treatment than in patients without complications (P<0.05).
Surgical treatment was not contraindicated for octogenarians with lung cancer. However, a relatively preoperative low arterial pO(2), high A-aDO(2), and long operation time may be risk factors for postoperative pulmonary complications in such patients. Surgeons must assess the preoperative data prudently to determine appropriate surgical strategy.
本研究旨在分析八旬老人原发性非小细胞肺癌肺切除相关风险，以助于更好地管理此类患者。
我们回顾了1981年至1998年间接受肺切除的35例80岁及以上患者的治疗结果。
5年生存率为39.8%。手术死亡率为0%，发病率为60%。有10例主要肺部并发症，包括细菌性肺炎后呼吸功能不全和痰液潴留。手术治疗后发生肺部并发症的患者术前动脉血氧分压显著更低，肺泡-动脉血氧分压差显著更高，且手术时间显著更长，与无并发症患者相比差异有统计学意义（P<0.05）。
手术治疗对八旬肺癌患者并非禁忌。然而，术前相对较低动脉血氧分压、较高肺泡-动脉血氧分压差及较长手术时间可能为此类患者术后肺部并发症的危险因素。外科医生必须审慎评估术前数据以确定合适的手术策略。
