Elderly patients with lobectomy and perioperative -

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Elderly patients with lobectomy and perioperative complications

Abstract Objective To summarize the experience of elderly surgical patients with lobectomy and further reduce postoperative complications and mortality, improve surgical outcomes. Method between 1990 to 2004 65 patients were treated over the age of 60 patients undergoing lobectomy. Of which 40 cases of lung cancer patients, lung benign tumor in 7 cases, 4 cases of lung abscess, pulmonary fungal ball and 5 cases of bronchiectasis, tuberculosis ball in 6 cases, 3 cases of inflammatory pseudotumor. Results after 13 cases of cardiac complications, pulmonary complications in 12 cases, 3 cases died of myocardial infarction after 3 days, 1 patient died of respiratory failure. 6.1% early mortality in this group. Conclusions Elderly patients with lung disease should be a positive attitude toward the surgery, reduce postoperative complications and mortality is the key to early diagnosis and perioperative management do a good job. Key words elderly patients with lobectomy perioperative complications with the aging of society, senior citizens, the incidence of lung disease in patients with a corresponding increase. As the physiological functions of elderly patients with low preoperative complications and postoperative complications,[link widoczny dla zalogowanych], and mortality, so in the perioperative treatment of complications and should be highly valued. Our hospital from 1995 to 2004 for the 65 patients over the age of 60 patients undergoing lobectomy, are reported below. 1 clinical data of patients in this group 65 cases, male 46, female 19 cases. The oldest 78 years old, minimum 62 years, mean age 68 years. Of which 40 cases of lung cancer, lung benign tumor in 7 cases, 4 cases of lung abscess, pulmonary fungal ball and 5 cases of bronchiectasis, tuberculosis ball in 6 cases, 3 cases of inflammatory pseudotumor. Line left lobectomy in 3 cases, the lower right lung lobectomy in 4 cases, the rest is a lobectomy. Preoperative cardiopulmonary dysfunction or significant ECG was abnormal in 34 cases (52.3%), decreased lung function in 16 patients (24.6%), including 3 patients with severe pulmonary insufficiency (VC53% ~ 54%, MVV39% ~ 48% , FEV46% ~ 39%, TVV700 ~ 800ml). 2 results 65 cases, 25 cases of early postoperative complications (38.4%), early complications of neoplastic disease in 9 cases (13%), and early complications of inflammatory diseases 16 cases (24.6%). Among them, 13 cases of cardiac complications, including atrial fibrillation in 9 cases, 15 cases of frequent premature ventricular contractions, sinus tachycardia 10 cases, 3 cases of heart failure. Acute myocardial infarction died from 3 patients, 1 patient died of respiratory failure, pulmonary complications in 12 cases, and the remaining 5 cases of pulmonary atelectasis. Attract bronchoscopy in 1 patient, the rest are by inhalation, shoot back and blow up balloons and other treatment expectoration cured. 5 cases of fungal infection in the respiratory tract, and therefore complicated bronchopleural fistula in 2 cases, 1 case for the right lower lobe bronchial fistula, the anti-inflammatory, drainage and supportive therapy such as conservative treatment. 1 case of right upper lobe bronchus fistula after failed conservative treatment by local breast changes do heal. Secondary bleeding after chest in 1 case, cured by re-thoracotomy to stop bleeding. Only 3 patients in this group 3 days after acute myocardial infarction, died. 1 patient died of respiratory failure, and the rest were clinically cured. 6.1% early mortality in this group.

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