Institute for Lung Diseases, Clinical Center of Serbia, Belgrade, Serbia.
Ann Thorac Med. 2009 Apr;4(2):54-9. doi: 10.4103/1817-1737.49413.
In septuagenarians, lobectomy is the preferable operation, with lower morbidity than for pneumonectomy. However, the 1-year impact of lobectomy on lung function has not been well studied in elderly patients.
Retrospective study including 30 patients 70 years or older (study group), 25 patients with chronic obstructive pulmonary disease (COPD) under 70 years (control group 1), and 22 patients under 70 years with normal lung function (control group 2) operated for lung cancer in a 2-year period. The study and control groups were compared related to lung function changes after lobectomy, operative morbidity, and mortality.
Postoperative lung function changes in the elderly followed the similar trend as in patients with COPD. There were no significant differences between these two groups related to changes in forced expiratory volume in the first second (FEV₁) and vital capacity (VC). Unlike that, the pattern of the lung function changes in the elderly was significantly different compared with patients with normal lung function. The mean postoperative decrease in FEV₁ was 14.16% in the elderly, compared with a 29.23% decrease in patients with normal lung function (P < 0.05). In the study and control groups, no patients died within the first 30 postoperative days. The operative morbidity in the elderly group was significantly lower than in patients with COPD (23.3% vs. 60%).
The lung function changes after lobectomy in the elderly are similar to those in patients with COPD. The explanation for such a finding needs further investigation. Despite a high proportion of concomitant diseases, the age itself does not carry a prohibitively high risk of operative mortality and morbidity.
在 70 岁以上的患者中，肺叶切除术是首选的手术方式，其发病率低于全肺切除术。然而，肺叶切除术对老年患者肺功能的 1 年影响尚未得到很好的研究。
回顾性研究包括 30 名 70 岁或以上的患者（研究组）、25 名 70 岁以下的慢性阻塞性肺疾病（COPD）患者（对照组 1）和 22 名 70 岁以下的肺功能正常的患者（对照组 2），这些患者在 2 年内因肺癌接受了手术。比较了研究组和对照组之间的肺叶切除术后肺功能变化、手术发病率和死亡率。
老年人术后肺功能变化趋势与 COPD 患者相似。这两组之间用力呼气第一秒量（FEV₁）和肺活量（VC）的变化没有显著差异。然而，老年人的肺功能变化模式与肺功能正常的患者明显不同。老年患者术后 FEV₁平均下降 14.16%，而肺功能正常的患者下降 29.23%（P<0.05）。在研究组和对照组中，没有患者在术后 30 天内死亡。老年组的手术发病率明显低于 COPD 组（23.3%对 60%）。
肺叶切除术后老年人的肺功能变化与 COPD 患者相似。需要进一步研究这种发现的原因。尽管合并症比例较高，但年龄本身并不会带来过高的手术死亡率和发病率。
