Effect of advanced age on peri-operative outcomes after robotic-assisted pulmonary lobectomy: Retrospective analysis of 287 consecutive cases
| Autor: | Tawee Tanvetyanon, Kathryn Rodriguez, Jacques P. Fontaine, Matthew R. Thau, Frank O. Velez-Cubian, Wei Wei Zhang, Kathryn S. Kass, Eric M. Toloza, Kavian Toosi, Carla Moodie, Joseph Garrett |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
Male medicine.medical_specialty Lung Neoplasms medicine.medical_treatment Operative Time 030204 cardiovascular system & hematology Postoperative Hemorrhage Lower risk Group B 03 medical and health sciences Pneumonectomy 0302 clinical medicine Postoperative Complications Robotic Surgical Procedures Carcinoma Non-Small-Cell Lung Recurrent laryngeal nerve medicine Humans Hospital Mortality Longitudinal Studies Lung cancer Aged Retrospective Studies Aged 80 and over business.industry Bronchial Injury Age Factors Retrospective cohort study Perioperative Length of Stay Middle Aged medicine.disease Surgery Oncology 030220 oncology & carcinogenesis Chest Tubes Female Geriatrics and Gerontology business |
| Zdroj: | Journal of geriatric oncology. 8(2) |
| ISSN: | 1879-4076 |
| Popis: | We investigated whether advanced age affects peri-operative outcomes after robotic-assisted pulmonary lobectomies.We retrospectively analyzed patients who underwent robotic-assisted lobectomy by one surgeon over a 5-year period. Rates of postoperative complications were compared according to age group. Other outcomes, such as intraoperative complications, hospital length of stay (LOS), and in-hospital mortality, were also compared.A total of 287 patients were included (mean age 67.1yr). Group A had 65 patients of advanced age≥75yr (range 75-87yr; 37 men, 28 women); Group B had 222 patients aged75yr (range 29-74yr; 95 men, 127 women). Group A had 10/65 (15.4%) patients with robotic-related intraoperative complications, compared to 10/222 (4.5%) for Group B (p=0.002), with the most frequent intraoperative complications being bleeding from a pulmonary vessel (10.8% vs. 4.5%, p=0.06), bronchial injury (3.1% vs. 0.9%, p=0.18), and injury to the phrenic or recurrent laryngeal nerve (1.5% vs. 0.4%, p=0.33). There were 28/65 (43.1%) patients in Group A with postoperative complications compared to 76/222 (34.2%) in Group B (p=0.19). While operative times were similar (p=0.42), Group A had longer median hospital LOS of 6±0.9days compared to 4±0.3days for Group B (p=0.02).While younger patients have lower risk of robotic-related intraoperative complications and shorter hospital LOS, elderly patients do not have increased overall or emergent conversion rates to open lobectomy, overall postoperative complications rates, or in-house mortality compared to younger patients. Thus, robotic-assisted pulmonary lobectomy is feasible and relatively safe for patients of advanced age. |
| Databáze: | OpenAIRE |
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