Yim A P
Department of Surgery, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, N.T., Hong Kong.
Surg Endosc. 1996 Sep;10(9):880-2. doi: 10.1007/BF00188474.
We review our experience in video-assisted thoracoscopic surgery (VATS) on patients over 75 years of age from a single institution.
From September 1992 to November 1995, 22 patients (13 males and 9 females with mean age of 78.1 years) underwent the following procedures: pleural biopsies with or without drainage and decortication (5), drainage of empyema (2), wedge lung biopsy (3), bullectomy and talc insufflation (1), major lung resections (5), mediastinal biopsy (1), pericardiectomy (3), and thymectomy (2). Pulmonary function tests of the entire group showed the mean forced expiratory volume in 1 s (FEV1) to be 1.46 1 (range 0.63-2.11) and forced vital capacity (FVC) to be 2.04 (range 0.98-3.55) 1.
There was no mortality. Morbidity included prolonged chest drainage over 7 days in two patients (9.1%), one of whom was discharged with a drainage bag. Particularly of note was the lack of postoperative pulmonary complications.
We conclude that VATS in the elderly population is safe. Age alone should not be a contraindication for major lung or mediastinal surgery.
我们回顾了在单一机构对75岁以上患者进行电视辅助胸腔镜手术(VATS)的经验。
从1992年9月至1995年11月,22例患者(13例男性和9例女性,平均年龄78.1岁)接受了以下手术:有或无引流及剥脱术的胸膜活检(5例)、脓胸引流(2例)、肺楔形活检(3例)、肺大疱切除术及滑石粉吹入术(1例)、肺大部切除术(5例)、纵隔活检(1例)、心包切除术(3例)和胸腺切除术(2例)。全组患者的肺功能测试显示,1秒用力呼气量(FEV1)平均为1.46升(范围0.63 - 2.11升),用力肺活量(FVC)平均为2.04升(范围0.98 - 3.55升)。
无死亡病例。并发症包括2例患者(9.1%)胸腔引流时间超过7天,其中1例患者带引流袋出院。特别值得注意的是术后无肺部并发症。
我们得出结论,老年患者行VATS是安全的。年龄本身不应成为肺部或纵隔大手术的禁忌证。