VIDEO-ASSISTED LOBECTOMY IN THE ELDERLY

Study objectives: Video-assisted lobectomy for pulmonary malignancy se ems to have potential merits, especially in compromised patients such as the elderly, This study was undertaken to assess the feasibility of this new approach in this special age group. Patients: Video-assisted lobectomy was attempted in eight patients older than 78 years of age with preoperatively diagnosed T1NO or T2NO lung carcinomas of peripher al origin, In one patient with squamous cell carcinoma, the tumor was diagnosed after surgery as metastasis from tongue carcinoma. The patie nts ranged in age from 78 to 85 years (average, 81.3 years). Results: The procedure was completed successfully in six patients (75%), while the other two patients underwent lobectomy after conversion to open th oracotomy because of bleeding from the pulmonary artery at the hilum i n one and extensive pleural adhesions in another. Among the six patien ts who underwent video-assisted lobectomy, there were no operative dea ths or serious complications attributable to this technique, although two patients had prolonged air leakage for 7 and 11 days, respectively . Conclusions: This approach, which is feasible even in patients older than 80 years, is likely to offer a benefit to such patients if they are selected properly, During this procedure, the possibility of wound extension in case of an intraoperative accident must always be borne in mind, especially in elderly patients, The advantage of this approac h remains undetermined in this special age group.