Lobectomy by video-assisted thoracic surgery for lung cancer patients aged 80 years or more.
Lobectomy by video-assisted thoracic surgery for lung cancer patients aged 80 years or more.
复制标题
电视胸腔镜手术对 80 岁及以上肺癌患者进行肺叶切除术。
DOI：
--
复制
发表时间：
2003
期刊：
影响因子：
--
通讯作者：
Shigeo Tanaka
中科院分区：
文献类型：
--
作者：
K. Koizumi;S. Haraguchi;T. Hirata;K. Hirai;I. Mikami;M. Fukushima;D. Okada;S. Yamagishi;Y. Enomoto;Keisuke Nakayama;H. Akiyama;Shigeo Tanaka
为了阐明电视辅助肺叶切除术对80岁以上肺癌患者的有效性，进行了一项回顾性研究，以评估临床结果。在1982年至2001年期间，914名患者在日本医科大学医院接受了原发性肺癌手术。其中，32例患者接受了肺叶切除术，其中17例患者的平均年龄为82岁（范围：80 - 91岁），接受了电视辅助肺叶切除术，15例患者的平均年龄为82岁（范围：80 - 86岁），接受了标准开胸肺叶切除术。对这32例患者的临床结局进行了回顾性评价。32例患者中有4例（12.5%）死亡，其中15例接受标准开胸肺叶切除术的患者中有3例（20%）死亡，17例接受视频辅助肺叶切除术的患者中有1例（5.9%）死亡。单因素分析显示，术前心肺疾病、术后1秒用力呼气量≥ 0.6 L/m2、失血≥ 700 ml、手术时间≥ 5 h和2种或2种以上术后并发症被认为是术后3个月内死亡的危险因素。在接受肺叶切除术伴纵隔淋巴结清扫的患者中，接受电视辅助肺叶切除术的患者的I期（IA+IB）5年生存率为55.6%，接受标准开胸肺叶切除术的患者为0%（IA=2，IB=2）。对于80岁或以上的肺癌患者，视频辅助肺叶切除术被认为提供了可接受的临床结局。但仍需进一步观察预后。
To clarify the usefulness of video-assisted lobectomy for lung cancer patient aged 80 years old or more, a retrospective study was conducted to evaluate the clinical outcome. Between 1982 and 2001, 914 patients underwent surgery for primary lung cancer at the Nippon Medical School Hospital. Among them, 32 patients underwent lobectomy, including 17 with a mean age of 82 years (range, 80 to 91 years) who underwent video-assisted lobectomy and 15 with a mean age of 82 years (range, 80 to 86 years) who underwent lobectomy by standard thoracotomy. Of these 32 patients, clinical outcome was evaluated retrospectively. Mortality was 4 (12.5%) of 32 patients consisting of 3 (20%) of 15 who underwent lobectomy by standard thoracotomy and 1 (5.9%) of 17 who underwent video-assisted lobectomy. Single variate analyses revealed that the presence of preoperative cardiopulmonary disease, 0.6 L or more of predicted postoperative forced expiratory volume in one second/m(2), 700 ml or more of blood loss, five hours or more of duration of operation and two or more of postoperative complications were considered as risk factors regarding mortality within three months postoperation. Among the patients who underwent lobectomy with mediastinal lymph node dissection, the 5-year survival rate at stage I (IA+IB) was 55.6% for patients who underwent video-assisted lobectomy and 0% for patients who underwent lobectomy by standard thoracotomy (IA=2, IB=2). Video-assisted lobectomy for lung cancer patients aged 80 years or more is considered to offer an acceptable clinical outcome. However, further observation on prognosis is necessary.