Mortality, complications and loss of pulmonary function after pneumonectomy versus sleeve lobectomy in patients younger and older than 70 years
Emanuel Melloul 1,
Bernhard Egger 1,
Thorsten Krueger 1,
Cai Cheng 1,
Francois Mithieux 1,
Christiane Ruffieux 1,
Lennart Magnusson 1,
Hans-Beat Ris 1*
1 Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
* To whom correspondence should be addressed. E-mail: hans-beat.ris{at}chuv.ch.
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Abstract |
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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. Keywords: Age; Pneumonectomy; Sleeve lobectomy; Pulmonary function; Morbidity; Mortality