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Mortality, complications and loss of pulmonary function after pneumonectomy vs. sleeve lobectomy in patients younger and older than 70 years

^a Division of Thoracic and Vascular Surgery, Centre Hospitalier Universitaire Vaudois, 1011 Lausanne, Switzerland
^b Division of Pneumology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
^c Institute of Social and Preventive Medicine, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
^d Department of Anaesthesiology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland

Corresponding author. Tel.: +41 21 314 24 08; fax: +41 21 314 23 58.

E-mail address: hans-beat.ris{at}chuv.ch (H.-B. Ris).

Retrospective single institution analysis of all patients undergoing sleeve lobectomy or pneumonectomy between 2000 and 2005. Seventy-eight patients underwent pneumonectomy (65 patients <70 years, 13 patients >70 years) and 69 sleeve lobectomy (50 patients <70  years, 19 patients >70 years). Pre-existing co-morbidity, surgical indication and induction therapy was similarly distributed between treatment by age-groups. In patients <70 years, pneumonectomy and sleeve lobectomy resulted in a 30-day mortality of 3% vs. 0 and an overall complication rate of 26% vs. 44%, respectively. In patients >70 years, pneumonectomy and sleeve lobectomy resulted in a 30-day mortality of 15% vs. 0 and an overall complication rate of 23% vs. 32%. In both age groups, pneumonectomy was associated with more airway complications (NS) and a significantly higher postoperative loss of FEV₁ than sleeve lobectomy (P<0.0001, P<0.03). Age per se did not influence the loss of FEV₁ and DLCO for a given type of resection. Sleeve lobectomy may have a therapeutic advantage over pneumonectomy in the postoperative course of elderly patients.

Key Words: Age; Pneumonectomy; Sleeve lobectomy; Pulmonary function; Morbidity; Mortality

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