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老年非小细胞肺癌患者的肺叶切除术:心脏合并症对手术结果的影响。

Lobar lung resection in elderly patients with non-small cell lung carcinoma: impact of cardiac comorbidity on surgical outcome.

机构信息

Department of Cardiothoracic and Vascular Surgery, Johannes Gutenberg University Mainz, Germany.

出版信息

Swiss Med Wkly. 2012 Dec 21;142:w13742. doi: 10.4414/smw.2012.13742. eCollection 2012.

Abstract

PRINCIPLES

The aim of this study was to evaluate the impact of cardiac comorbidity on the perioperative morbidity and mortality after lobar lung resection for lung cancer in patients aged 70 years and older.

METHODS

The medical records of all 68 patients ≥70 years, who underwent lobar lung resection for non-small cell lung cancer (NSCLC) from 2003 to 2011 at our department, were reviewed retrospectively. Twenty-two patients with a mean age of 76.3 years had cardiac comorbidities (Group A) including previous cardiac operations in 4 patients, previous myocardial infarction in 5 patients, previous coronary stent insertion in 3 patients, medically treated coronary artery disease in 10 patients and medically treated valvular heart disease in 2 patients whereas 46 patients (mean age = 74.5 years) had no previous cardiac history (Group B).

RESULTS

There were no significant differences in postoperative morbidity (13.6% in Group A vs. 17.4% in Group B) between both groups. No in-hospital mortality was observed in both groups.

CONCLUSION

In our experience lobar lung resections for NSCLC in elderly patients with cardiac comorbidity seem to be a safe therapy option for this increasing subpopulation. Though, our retrospective data with the small number of study objects require further confirmation in larger prospective trials.

摘要

原则

本研究旨在评估 70 岁及以上患者因肺癌行肺叶切除术时合并心脏疾病对围手术期发病率和死亡率的影响。

方法

回顾性分析了 2003 年至 2011 年我科 68 例非小细胞肺癌(NSCLC)行肺叶切除术的年龄均≥70 岁患者的病历资料。其中 22 例患者(平均年龄 76.3 岁)患有心脏合并症(A 组),包括 4 例先前有心脏手术史、5 例有心肌梗死史、3 例有冠状动脉支架置入史、10 例有经药物治疗的冠状动脉疾病和 2 例有经药物治疗的瓣膜性心脏病;46 例患者(平均年龄=74.5 岁)无既往心脏病史(B 组)。

结果

两组患者术后发病率(A 组为 13.6%,B 组为 17.4%)无显著差异。两组均无院内死亡。

结论

根据我们的经验,对于患有心脏合并症的老年 NSCLC 患者,肺叶切除术似乎是一种安全的治疗选择。然而,我们的回顾性数据和研究对象数量较少,需要进一步在更大的前瞻性试验中得到证实。

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