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80岁以上肺癌患者的外科治疗:术后并发症调查

[Surgical treatment of lung cancer over 80 years of age: investigation from post operative complications].

作者信息

Tanita T, Tabata T, Shibuya J, Noda M, Hoshikawa Y, Ueda S, Hasumi T, Sakuma T, Ashino Y, Ono S

机构信息

Department of Thoracic Surgery, Tohoku University, Sendai, Japan.

出版信息

Kyobu Geka. 1995 May;48(5):354-9.

PMID:7745855
Abstract

Seventeen patients with lung cancer over 80 years were treated surgically from 1983 through 1993 in our department. Thirteen patients were male and four were female. The histology of the tumor was adenocarcinomas, squamous, large and small cell carcinomas, in 9, 6, 1 and 1 cases, respectively. More than single lobectomy was performed in each patient. Unilateral pulmonary occlusion test was applied in patients whose expected contralateral FEV1.0/BSA was less than 800 ml.m2, or expected residual FEV1.0/BSA was less than 850 ml.m-2. Postoperative cardiovascular complications, such as PAT, PAC, PVC or Af, were seen in 9 patients, respiratory problems, namely, sputa retention, retained secretions or atelectasis, in 7 patients. Blood chemistry and hematology were performed for about three weeks after operations, and found increases in serum transaminases, and leukocytosis. However, there were no operative death. We conclude that some patients over 80 years of age are candidates for surgery after careful cardiopulmonary preoperative evaluation.

摘要

1983年至1993年,我科对17例80岁以上的肺癌患者进行了手术治疗。其中男性13例,女性4例。肿瘤组织学类型分别为腺癌9例、鳞癌6例、大细胞癌1例、小细胞癌1例。每位患者均接受了超过单叶切除术的手术。对预计对侧FEV1.0/BSA小于800 ml.m2或预计残余FEV1.0/BSA小于850 ml.m-2的患者进行了单侧肺阻塞试验。9例患者出现术后心血管并发症,如房性早搏、房性心动过速、室性早搏或房颤;7例患者出现呼吸问题,即痰液潴留、分泌物潴留或肺不张。术后约三周进行了血液化学和血液学检查,发现血清转氨酶升高和白细胞增多。然而,无手术死亡病例。我们得出结论,经过仔细的心肺术前评估,一些80岁以上的患者适合手术治疗。

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